Patients Abandoning Treatment
Patients left waiting for approval delay or quit — sicker later, costlier to treat.
Award-Winning Prior Auth Automation
The Problem Is Bigger Than a Slow Process
Prior auth is a clinical risk, not just an admin burden — every failure compounds on both sides.
Clinical Reviewers Buried in Routine Work
Routine, repeatedly approved requests still reach reviewers — complex cases wait.
Providers Fighting Your System Instead of Working With It
Opaque criteria push providers to over-document and chase approvals endlessly.
Denial Rates Creating Costly Appeal Workloads
Every overturned denial costs twice — review plus appeal — and strains providers.
Manual Review Means Inconsistent Decisions
Two reviewers, same case, different decisions — a medical and financial liability.
How the Platform Works — From Submission to Decision
Only what needs a human escalates.
What You Get on the Payer Operations Dashboard
Real-time visibility across the authorisation pipeline.
Live Authorisation Pipeline & Auto-Approval Rate
Every request by status and provider.
Clinical Reviewer Workload & Turnaround
Decision time plus backlog alerts.
Denial Analytics & Provider Performance
Denial, appeal, and overturn rates.
What Payer Teams Are Experiencing After Going Live
Each result traces to a real prior-auth problem we fixed.
Book a Live Demo70%
Of reviewer time was going to straightforward approvals. AI handles those now. Reviewers focus on complex cases. Job satisfaction up noticeably. — VP Clinical Operations, National Health Insurer, Mumbai
6 hrs
Average turnaround for routine requests, down from 4.2 days. Provider frustration measurably reduced. Satisfaction scores moved within three months. — Chief Medical Officer, Managed Care Organisation, Bengaluru
80%+
Appeal overturn rate on one cardiac denial reason — caught in analytics. Criteria updated, denials stopped. — Head of Utilisation Management, Regional Health Plan, Hyderabad
83%
Reduction in handling time per request. Routine volume automated from day one. Auto-approval rate improves month-over-month as the AI calibrates.
Zero
Appeal backlog post-implementation. Every appeal arrives with full case history assembled — no reviewer starting from scratch.
Same day
Turnaround for urgent cases. Urgency signals detected automatically from clinical notes. Urgent requests skip the standard queue.
Who This Platform Serves
Built for every payer-side organisation.
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Health Insurance Companies
Health Insurance Companies
AI prior auth cuts cost per decision at volume.
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Managed Care Organisations
Managed Care Organisations
Meet turnaround targets without new headcount.
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Government Health Schemes
Government Health Schemes
NHCX and ABHA-ready adjudication at scale.
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Third Party Administrators
Third Party Administrators
Faster decisions and fewer appeals network-wide.
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Self-Insured Employers & Benefit Administrators
Self-Insured Employers & Benefit Administrators
Prior auth without clinical infrastructure.
Built to the Standards That Prior Authorisation Actually Operates Under
Regulatory, interoperability, coding, and security standards built directly into the platform.
Indian Regulatory
IRDAI & Government Scheme Compliance
IRDAI and scheme requirements — audit trails and turnaround SLAs.
Interoperability
NHCX, ABHA & FHIR Integration
Interoperability standards enabling submission via existing EHR.
Coding Standards
Clinical Coding & Classification
Coding standards applied during clinical necessity review.
EHR Integration
Provider System Compatibility
EHR and practice-management integrations for direct submission.
Data Privacy & Security
Privacy & Security Frameworks
Privacy and security across every data store and audit trail.
Audit & Compliance
Full Decision Audit Trail
Every decision logged — criteria, outcome, reviewer, timestamp.
Prior Auth Should Protect Clinical Appropriateness. Not Block It.
Prior auth should ensure evidence-based care — not route every request through the same manual process. AI handles the routine. Reviewers focus on what needs expert judgment.
Book a Prior-Auth Demo
Award-Winning AI Development & Consulting
100 Fastest Growth Companies
Global Spring Winner
Top App Development Company
AWS Partner Network
Google Cloud Partner
Highly Rated on Trustpilot
Verified Agency
Top App Development Company
ASSOCHAM Member
Frequently Asked Questions
[ 1 ]
How does the AI apply our specific clinical criteria rather than generic guidelines?
Configured to your own clinical criteria, not industry generics — changes apply instantly.
[ 2 ]
What happens with requests where clinical judgment genuinely differs from guidelines?
They go to your reviewers, each with a full case summary and the AI's preliminary read.
[ 3 ]
How does this handle urgent and emergency authorisation requests differently?
Urgency scoring sends time-sensitive requests straight to a same-day reviewer.
[ 4 ]
Can providers submit through their existing EHR systems?
Yes — FHIR electronic prior auth from Epic or Cerner, plus portal and API submission.
[ 5 ]
How quickly does the auto-approval rate improve after implementation?
Routine auto-approvals from week one, with the rate calibrating over 60 to 90 days.
[ 6 ]
Is the system compliant with IRDAI regulations and Indian health insurance requirements?
Yes — IRDAI-aligned, NHCX and ABHA-ready, with full audit trails for regulatory review.
Global presence
