Built for the most complex workflows in healthcare.

Intake

We build a lightweight integration to your CRM / case management tool to pull in patient documents automatically, or patients, providers, and patient access teams can upload documents directly. We then use AI to split and label each document. We pull in updated payer policies and other relevant information from our coverage database, and we can run benefits verification.

Case Assessment

Our AI reviews the full patient file line-for-line against the exact payer policy, clinical guidelines, and product evidence in minutes, and flags missing documentation to prevent sending an incomplete submission. If a policy doesn’t exist yet, the AI can still generate a robust justification based on available clinical evidence and guidelines.

Extracted Data Analysis

Reviewers can easily verify any component of the case by clicking the citation, which displays the source document with highlighted references alongside the analysis.

Customized Justification Letter

The platform generates fully cited prior auths, appeals, and determination documents that incorporate payer language and map every statement to the criterion it satisfies, including policies and guidelines.

Follow-up calls to payers

After submission (whether by the provider, patient, or your team), we use Voice AI technology to directly call payers just like a human rep would. We can follow-up on a case’s status, advocate for additional reviews, etc.

Intelligence and Audit Trail

Real-time analytics expose pass/fail drivers and ROI metrics, while one-click exports deliver a policy-traceable, audit-ready packet for payers, regulators, or internal QA.