Prior Authorization AI
Prior Authorization Support Built Around Your Team
AuthParency combines AI-assisted workflows with prior authorization expertise to help reduce delays and improve visibility - designed to work with your EHR and PM system.
Schedule a DemoCore Capabilities
AI-Assisted Prior Authorization
Documentation & Requirement Review
AI helps review historical patterns, diagnosis codes, and procedure information to support case prioritization and highlight documentation gaps before submission.
- Case prioritization support
- Payer-requirement reference matching
- Documentation gap alerts
- Helps reduce rework for your team
Medical Necessity Support
AuthParency helps cross-reference configured payer-specific medical necessity guidelines, flagging potential mismatches for staff review and aligning documentation to available criteria.
- Configured payer policy reference
- Payer-specific criteria matching support
- Clinical documentation recommendations
- Appeals support with supporting evidence
Structured Turnaround Workflow
AI-assisted automation helps with documentation parsing, data extraction, and submission preparation, supporting faster review where payer and case conditions allow.
- Supports faster case review
- Same-day workflow support where available
- Real-time status tracking dashboard
- Expiration and renewal alert support
AuthParency helps you
- Identify potential documentation and eligibility issues earlier
- Help prioritize requests using configured business rules
- Support medical necessity review against payer-specific criteria
- Reduce patient days-to-care with more consistent follow-up and status updates
- Flag potential non-reimbursable services before submission for review
- Send proactive alerts before authorizations lapse
- Encode your staff's payer expertise into a configurable Business Rules Engine
- Review prior authorization denial patterns through reporting
How it works
- Transparent process with authorization status visibility at every stage
- AI-assisted matching of drug and procedure protocols to configured payer formularies
- Case pathway views by facility, network, and plan, where configured
- Audit logs to support compliance, appeals documentation, and denial trend review
- Expiration alerts - proactive notifications before authorizations lapse
- Business Rules Engine - encode your staff's payer expertise into a living knowledge base