Practical AI for Prior Authorization Work
AuthParency's AI is applied to well-defined prior authorization tasks and is continuously refined using feedback from configured payer workflows.
See the AI in ActionCore AI Capabilities
AI Built for Prior Authorization Tasks
Documentation & Case Review Support
AI helps review available clinical and administrative information, diagnosis codes, and procedure patterns to support case prioritization, before submission.
Medical Necessity Support
A configurable library of payer-specific medical necessity criteria. AuthParency helps cross-reference each request, flagging potential mismatches for review.
Business Rules Engine
Encode your staff's institutional knowledge of payer behavior into a configurable, AI-assisted rules engine.
Payer Requirement Tracking
Track configured payer requirement changes over time. When available information changes, AuthParency helps alert your team.
Continuously Learning
Built on Healthcare Experience. Improving With Use.
AuthParency's AI is informed by our healthcare operations background and is refined as payer policies, criteria, and formularies change. Case outcomes help improve future support for your team.
Human-Reviewed Learning
Refined using outcomes from approved and denied PA cases, with human review.
Configured Updates
Payer policy changes are reflected in supporting workflows as they are confirmed.
Feedback Loops
Outcomes from your cases help improve future support for your team.