Healthcare — Prior‑Auth Packs

Healthcare — Prior‑Auth Packs

Summarize charts + eligibility. 🏥 Reduce turnaround 7–10d → 1–2d.

Acquire

• EHR charts, eligibility APIs, guidelines
• Provider notes & imaging

Enrich

• Normalize clinical data; de‑identify as required
• Map to coverage criteria

Reason

• Draft prior-auth summary & medical necessity rationale
• Checklist of required docs

Orchestrate

• Route to payer portal; track status
• Escalate exceptions

KPIs & Outcomes

• Turnaround 1–2d
• Denials ↓

Pilot Rollout

1. Pilot 1 specialty
2. Validate with clinical leadership
3. Measure first-pass approval