PAHub
As Prior Authorization volumes continue to rise, and as specialty drugs create additional clinical complexities, Health Plans, Pharmacy Benefit Managers (PBMs) and Third-Party Administrators (TPAs) are challenged to adapt while maintaining or improving operational and clinical efficiencies. PAHub, is a HITRUST certified solution that puts the tools at your fingertips to streamline and control all clinical, compliance and administrative aspects of Prior Authorization at the point-of-care to improve compliance, reduce turn-around times and costs. By leveraging the latest technologies for data mining, data analytics, content management and advanced decision support trees, PAHub, enables customers to automate the end-to-end prior authorization process.
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AuthParency
Prior Authorization with AuthParency
Prior authorization is a growing administrative burden for healthcare providers. Our automated prior authorization solution, AuthParency™, is powered by AI and machine learning (ML). This advanced system can cut your team’s prior authorization time in half. It is also compatible with all EHR and practice management systems
AuthParency helps:
Analyze payers’ tendencies
Reduce patients’ days to care
Improve patient outcomes
Stop losses from non-reimbursable services
Identify financial toxicity burdens
Analyze population health data
Track disparities
Pharmaceutical companies
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Silna Health
Silna Health’s Care Readiness Platform handles all prior authorizations, benefit checks, and insurance monitoring upfront to make sure patients are clear to receive care while providers gain capacity to focus on treatment. Its AI‑powered engine manages the entire prior authorization workflow, from tracking upcoming authorizations and sending weekly reminders to submissions and follow‑ups, automatically applying industry‑proven rules and escalating exceptions for human review. Specialty‑specific benefit checks verify coverage, accumulations, authorization requirements, and visit limits in real time, delivering accurate quotes at intake. Continuous insurance monitoring flags lost coverage, detects new plans, and safeguards against eligibility lapses. Designed for zero extra headcount, Silna ingests data directly from EMRs and practice management systems, offers configurable rule sets and strategic guidelines, and presents clear dashboards with incremental revenue insights.
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GenHealth.ai
GenHealth.ai is a healthcare-focused generative AI platform built on a proprietary Large Medical Model (LMM) trained using data from over 100 million patient histories rather than natural language. The LMM processes medical codes and events to predict future patient trajectories, forecast costs, and simulate clinical pathways with higher accuracy and fewer hallucinations than traditional large language models. It supports a suite of purpose-built applications, including Intake Automation (PDF routing, data extraction, medical necessity), Prior Authorization Agent for automated adjudication, and G‑Mode analytics, which enables users to “chat” with historical and projected population‐health data via natural language, all without coding. This AI‑powered co‑pilot has shown 94 % accuracy in prior‑auth cases, a 120× improvement in medical loss ratio forecasting, and 110 % better cost prediction versus standard HCC scoring.
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