For health plans
Automated Prior Auth with AI
Policies to Decision Trees
Utilization Insights from AI
Benchmark & Compare Policies
Faster Response Times
Decision Recommendations
Audit-Proof Denial Reasons
The most intelligent UM/PA software ever built
Intake
- Extract structured patient data from all sources including faxes, HL7v2, C-CDA, FHIR and call centers transcripts
- Ingest medical policies from PDFs, web pages and portals
- Update daily, on change, or upload PDFs directly
By the brains that got 50+ plans compliant
AI Review
- Get early abuse detection notifications
- Generate individual risk assessments per submission
- Identify next best action for care management
- Generate provider gold card recommendations
Human readable PA logic explanations
Decision
- Generate determination decision recommendations for clinical review
- Follow plan-specific workflows using coverage details and medical policies
- Automatically generate return letters
- Auditable citations for all denials and requests for more information
No manual logic, Our AI does the work