Clinical policy automation

Prior Authorization Decision Support

Evaluates a pre-approval request against published CMS coverage determinations. The language model never decides. It judges each coverage criterion individually — met, not met, or unknown — and a deterministic rule engine turns those judgements into an outcome, citing the policy passage it used.

Approve — every criterion explicitly met Deny — a criterion explicitly failed Route to human — cannot decide, and says why
Request
Edit freely — removing a documented fact is the fastest way to see the system abstain.
Decision

No request evaluated yet

Pick a scenario on the left, or write your own note, then evaluate. The first call takes a few seconds.