Step 1
Order in
Procedure or medication order from the EHR
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Solution
QAO PriorAuth Pack
Payer-rule-aware prior authorization packets assembled from the clinical record.
INDUSTRY Healthcare & Life SciencesSOLUTION FAMILY AI and Autonomous Operations
The problem it solves
Staff check each payer's rules, search the chart for supporting evidence and fill forms by hand. Missing documents send requests back and care is delayed.
How it works
Four steps. A person decides.
Step 2
Payer rules agent
Checks requirements and gathers evidence
Step 3
Coordinator review
Fixes gaps and approves the packet
Step 4
Payer submission
Sent electronically and tracked to decision
What's inside
Built for the real work.
Payer rule library
Requirements by payer and service, kept current.
Evidence gathering
Notes, results and history pulled from the record.
Gap check
Missing items flagged before submission.
Electronic submission
Ready for payer prior authorization APIs.
Built with
FHIRRules engineLLM gatewayPythonPostgresReact
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