Paper and fax-based prior authorization forms require manual review, data entry, and are often incomplete or filled out inaccurately. Our solution uses OCR and AI to capture form data automatically, eliminating time-consuming data entry.

Clinical review can be a costly and time-consuming process due to lengthy medical record submissions. Our AI technology automatically summarizes patient medical records so clinical reviewers can increase their productivity up to 30%.

Unnecessary PA submissions create needless cost, and many submission decisions can be either partially or fully automated. Our solution allows configuration of your PA submission rules so unnecessary submissions can be reduced or eliminated, and non-complex cases can be decided automatically.

Traditional PA processes involve too many phone calls, emails, and manual fax handling. We automate communication with provider submitters via portal chat, electronic fax, and synthesized voice calls.

Most portal solutions offer nothing more than a submission channel, without comprehensive status communication and inventory management. Our portal provides a unique guided experience that ensures complete and accurate submissions, and instantly connects your PA staff with submitting providers for fast communication turn-around.

The key to full automation is interoperability with EHR systems, UM tools, claims platforms. What’s more, there are expected upcoming regulations to mandate interoperable capabilities. Our platform is API-ready and provides EHR connectivity via both FHIR and non-FHIR connections.