Prior authorization takes an average of 14 business hours per request. 94% of physicians report care delays from prior auth. Practices spend $68K per physician annually on prior auth administration. 30% of prior auths are initially denied. Tracking prior auth status across 20+ payers requires daily phone calls. CMS finalizes Prior Auth Rule requiring electronic processing by 2026.
AI-powered prior authorization platform that auto-fills forms from clinical documentation, submits electronically to payers, tracks status in real-time, generates appeals for denials, and predicts approval probability before submission.
Specialty practices requiring prior auth for most procedures (orthopedics, oncology, radiology), hospitals processing 500+ prior auths per month, and prior auth outsourcing companies managing authorizations for multiple practices
CMS Prior Auth Rule mandates electronic processing by 2026. Physicians are demanding relief from prior auth burden. AI can extract clinical data for form completion. Payer electronic submission APIs are expanding. $68K/physician annual cost is unsustainable.
Per-auth: $15/submission (vs $68 manual cost), $25/appeal. Platform: $299/mo (up to 100 auths/mo), $599/mo (500 auths), $999/mo (unlimited + API). Annual: 20% discount.
14 hours per auth, $68K/physician/yr, 30% denial rate, care delays
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