Connect a fragmented provider workflow
Bring documentation tasks, status checks and follow-up into one accountable work queue tied to the source encounter or order.
The useful outputA request lifecycle with visible pending work and source context.
For provider operations, payer platforms and healthtech products
Move the request forward. Keep people in control.
Reduce fragmented work between coverage checks, documentation, submission and follow-up. We build prior authorization workflow software that connects the process and makes unresolved requests visible to the team responsible.
Map your authorization workflowProvider organizations, payer teams and product companies coordinating non-drug prior authorization workflows.
Inside the workflow
- 01Discover
Requirements and available exchange route
- 02Prepare
Source-backed documentation and human review
- 03Submit
Correlated request, attachments and receipt
- 04Resolve
Decision, more information or accountable follow-up
Illustrative workflow · scope tailored to your environment
Start with the real problem
A submitted request is not an approved authorization.
Automation can create false confidence when a portal receipt, API response or sent document is treated as a completed outcome. We model the full request lifecycle, including missing evidence, changed service details, additional-information requests and manual review. This keeps operational progress distinct from the payer’s decision.
Your starting point
Different situations.
A deliberate scope for each.
Add a digital prior authorization capability
Integrate supported EHR and payer interfaces while preserving review for information that cannot safely be inferred.
The useful outputAn end-to-end request flow with correlated evidence and responses.
Improve an existing automation
Investigate duplicate requests, unclear statuses and untracked exceptions before adding more automation volume.
The useful outputA reliability and exception-handling plan with measurable workflow indicators.
The Engineering Engagement
Here is what
we can take on.
Workstreams are selected around your priorities. Each comes with an output your team can inspect, test and own.
Workflow and route discovery
Identify payer products, service types, source systems and supported channels. Separate API availability from operational permission.
Documentation preparation
Bring approved source information into the request with provenance. Route absent or uncertain answers to qualified review.
Request orchestration
Correlate submissions, attachments, updates and asynchronous responses. Persist workflow state across restarts.
Work queues and handoffs
Show the next action, accountable team and relevant evidence for pending or failed requests.
Reporting and operations
Track workflow latency, unresolved work and source failures without presenting technical receipts as clinical or financial decisions.
Expertise is in the decisions
Resolve these before
they become rework.
Choose APIs where the partner supports the workflow
CRD, DTR and PAS serve different portions of a prior authorization journey. Validate the actual supported versions and channels; do not assume all counterparties expose the same end-to-end capability.
Keep the decision authority explicit
Clinical review and payer adjudication remain with authorized people and systems. Automation prepares, routes and tracks work; it does not create approval authority.
Model amendments, not only first submissions
A service can change, evidence can be added and a request can need correction. Preserve correlation and history instead of creating unrelated new requests.
A clear engagement also has clear boundaries.
Not a promise of approval or reimbursement
The payer decides authorization under its applicable policies. Our software work does not guarantee approval, payment or a particular clinical outcome.
Not the whole CMS interoperability program
This page focuses on operational workflow automation. A CMS-0057-F program can require other APIs and operational workstreams; review applicability separately.
From discussion to delivery
Visible progress.
Reviewable at every step.
- 01
Follow one real workflow
Map a representative service and its exception paths with the team.
- 02
Prove the exchange boundary
Validate source information, partner access and response behavior.
- 03
Build the accountable workflow
Implement durable state, review queues and correlated exchange.
- 04
Validate end to end
Exercise pending, additional-information, denied and corrected scenarios.
Start with discovery, a defined build, or a focused modernization.
We agree the scope, dependencies, acceptance criteria and commercial model before implementation. Your existing team can stay involved throughout.
Find the right starting point ↗Is this an API integration or a full workflow product?
It can be either, but they are different scopes. We define whether you need a connector, an orchestration layer or a user-facing work queue and documentation experience.
Can you use CRD, DTR and PAS?
We can scope these standards-based workflows where supported by your EHR and payer counterparties. Version compatibility and onboarding need validation.
Will it automatically approve requests?
No. Approval belongs to the authorized payer process. The software helps prepare, exchange, track and follow up on requests with appropriate human review.
How is this different from your CMS-0057-F offering?
The automation offering targets the day-to-day authorization workflow. The CMS offering addresses a broader payer interoperability program with distinct applicability and evidence requirements.
A useful first conversation
Map your authorization workflow.
Tell us what exists today, who uses it and where the workflow breaks. We’ll discuss the scope, access dependencies and the next practical step.
Come with context. Leave with a clearer direction.
Prefer to contact the team directly? ↗A product overview and a de-identified workflow are enough to start. No patient records or credentials are needed.
Thank you. Your enquiry has been received. Our team will review your requirements.
Standards and reference material
These are independent reference sources, not endorsements. Applicability, platform access and current requirements are confirmed for your project.