PriorAuth AI™ by Clinaptix is purpose-built to maximize first-pass approval rates for biologic & topical drug therapies — designed for Medical Assistants, backed by FDA labeling, payer policies & clinical evidence.
Industry data reveals a system under serious strain — and your patients, staff, and bottom line are all paying the price.
94% of physicians say prior authorizations negatively impacts clinical outcomes. 1 in 4 (29%) report PA led to a serious adverse event. 82% say PA leads to treatment abandonment.
Practices complete 39 PAs per physician per week. Staff spend 13 hours per week on prior authorization tasks. 40% of practices have staff working exclusively on prior authorization.
88% say prior authorization drives higher utilization — ER visits, hospitalizations & out-of-pocket costs. 75% report prior authorization denials are increasing year over year.
A seamless four-step process that turns complex prior authorization into a guided, accurate, and fast workflow for your clinical staff.
Pulls patient treatment plans from your EHR automatically — no duplicate data entry, no manual lookups.
Cross-references FDA labeling & payer coverage requirements in real time to confirm clinical and coverage eligibility.
Determines prescriber eligibility and maps the appropriate prescribing pathways to maximize first-pass approval.
Delivers clear, compliant, submission-ready guidance and checklists directly to your clinical staff.
Every feature is designed to eliminate the root causes of prior authorization denials, delays, and administrative waste.
Cross-references FDA-approved drug labeling, clinical guidelines & payer-specific coverage criteria in real time — every submission is clinically sound and defensible.
EHR integration pulls patient treatment plans automatically. Medical Assistants receive clear, step-by-step documentation checklists — no guesswork, no rework.
Identifies prescriber eligibility and maps prescribing pathways upfront — slashing denials, eliminating appeals & preventing costly downstream delays.
No complex IT setup required. Connects directly to your existing EHR system and pulls relevant patient data automatically for every prior authorization request.
Everything your practice needs to stop losing time and patients to prior authorization delays.
Maximized first-pass approval rates — fewer denials, dramatically less rework and appeals.
FDA-approved drug labeling mapped to every PA submission — always evidence-based.
Real-time payer eligibility checks against coverage requirements before every submission.
Medical Assistant-ready guidance — clear checklists, no deep clinical expertise required.
EHR-integrated — patient data pulled automatically, zero duplicate data entry for staff.
Complete audit trail of clinical & regulatory evidence supporting every submission.
PriorAuth AI™ gets your biologic therapies approved — faster, and first time. Request a demo today and see how Clinaptix can transform your PA workflow.