epitomi® Prior Authorization

Accelerate your prior auth workflows with AI-driven document intelligence,
OCR, and clinical rules.

Prior Authorization Workflow Intelligence

Transform manual PA fax processing into intelligent, automated workflows while preserving existing payer submission channels. epitomi® PA enhances your current processes with proven clinical NLP and CMS 2026 compliance readiness.

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Manual PA Processing

8-10 Days

epitomi® PA Intelligence

2-3 Days

Workflow Intelligence for Every Stakeholder

Enhance your existing PA processes without disruption while meeting CMS 2026 requirements

Reduce PA Burden While Maintaining Clinical Oversight

Process PA requests 50-75% faster while preserving clinical quality controls and meeting CMS 2026 compliance requirements. epitomi® PA enhances your existing workflows without requiring provider system changes.

Clinical Review Efficiency

Intelligent pre-processing routes only complex cases to clinical reviewers, reducing medical director workload by 60% while maintaining quality oversight.

CMS 2026 Compliance

Built-in 72-hour urgent and 7-day standard processing workflows with automated denial rationale and public metrics reporting.

Provider Satisfaction

Reduce provider abrasion through faster decisions and clearer communication while preserving existing submission workflows.

Medical Necessity Intelligence

AI-powered analysis of clinical guidelines and evidence extraction ensures appropriate utilization management decisions.

Health Systems and Providers: Accelerate PA Approvals Without Workflow Disruption

Reduce the time your staff spends on PA requests while maintaining existing EHR workflows. epitomi® PA integrates seamlessly with your current processes to deliver faster approvals and improved patient access to care.

Revenue Cycle Acceleration

Faster PA approvals reduce care delays and accelerate revenue cycle with fewer denials and appeals requiring manual intervention.

Physician Workflow Preservation

No disruption to existing EHR documentation or submission processes - epitomi® enhances without replacing your current workflows.

Administrative Burden Reduction

Automated status tracking and intelligent notifications reduce staff time spent on PA follow-up and manual coordination.

Seamless EHR Integration

Direct connectivity with Epic, Cerner, and other EHR systems for automated PA initiation and real-time status updates.

ACOs and Risk Organizations: Optimize Care Coordination and Cost Management

Accelerate member access to necessary care while maintaining cost controls through intelligent PA processing. epitomi® PA supports your shared savings and quality improvement initiatives.

Care Gap Closure

Faster PA decisions enable timely preventive care and chronic disease management, improving quality scores and member outcomes.

Cost-Effective Utilization

AI-driven medical necessity analysis ensures appropriate care utilization while reducing unnecessary administrative costs.

Provider Network Satisfaction

Improved PA turnaround times strengthen provider relationships and support network retention and growth.

Proven PA Workflow Intelligence

Faster approvals for quality-improving interventions support MSSP benchmarks and shared savings optimization.

Platform Capabilities

Decade-plus healthcare NLP expertise enhanced with
cutting-edge generative AI capabilities

Clinical NLP Engine

Advanced natural language processing trained on healthcare documents, medical terminology, and PA decision criteria with proven accuracy across millions of clinical documents.

Intelligent Fax Processing

Automated intake, classification, and routing of PA fax documents with OCR enhancement and machine learning for continuous accuracy improvement.

Medical Necessity Analysis

AI-powered evaluation of clinical evidence against medical guidelines and payer policies.

Seamless Integration

Seamless integration with existing PA processes and leading care management platforms, enhancing workflows with intelligent automation.

Real-Time Analytics

Comprehensive reporting and analytics for PA volume, turnaround times, approval rates, and CMS compliance metrics.

Enterprise Security

HIPAA compliant, SOC2 certified platform with comprehensive audit trails, data governance, and enterprise-grade security.

Powered by the epitomi® Clinical Data Platform

epitomi® PA extends our proven clinical data platform with specialized prior authorization workflow intelligence. Our foundation combines 10+ years of healthcare NLP expertise with cutting-edge generative AI capabilities, processing millions of clinical documents with enterprise-grade security and FHIR-native interoperability.

Explore the epitomi® Platform

Ready to transform Healthcare Intelligence across your Organization?