AI agent that reads payer medical policy in real time, cross-references your documentation, and flags denial risk — all before the claim submits.
No more guessing whether a prior auth will stick. Denial Fighter reviews it against live payer policy in seconds.
Provider submits a prior authorization request with supporting clinical documentation via FHIR integration.
Agent reads the relevant payer medical policy, extracting medical necessity criteria, documentation requirements, and exclusion rules.
Returns a denial risk score with specific gaps, missing documents, and recommended remediation steps — before the claim goes out.
Built for the reality of prior auth — where policy changes daily and missing one criterion means a denial.
Automatically parses payer medical policies and extracts criteria — no manual rule entry needed.
Compares documentation against policy requirements and flags exactly what's missing or insufficient.
Integrates directly with EHR systems via FHIR. No middleware, no custom APIs required.
Each request gets a clear risk rating with specific, actionable remediation steps.
Results return within seconds — providers can fix gaps before the claim ever submits.
Designed by a PA who has dealt with prior auth denials firsthand. Solves real workflow problems.
Built on battle-tested infrastructure designed for healthcare data.