From 3 Days to 3 Minutes. AI Prior Auth.
Zabrizon's prior authorisation AI delivers real-time clinical decision support against your medical policies — dramatically reducing turnaround time, physician burden, and care delays while maintaining full compliance with CMS interoperability requirements.
Why Prior Auth Is Broken — and Costly
Prior authorisation consumes over $31B annually in US healthcare administrative costs, with no corresponding improvement in care outcomes.
3+ Day Average Turnaround
Manual prior auth workflows require fax, phone, and manual policy lookup — creating multi-day delays that postpone urgent care.
Physician Burnout & Abandonment
86% of physicians report prior auth causes patient care delays; 33% say it leads to treatment abandonment. A direct patient safety risk.
CMS Compliance Pressure
The 2024 CMS Interoperability Rule mandates FHIR-based ePA APIs, 72-hour urgent and 7-day standard response SLAs — most legacy systems can't comply.
Inconsistent Policy Application
Manual review produces inconsistent outcomes as reviewers apply coverage criteria differently, creating liability and appeal volume.
AI-Powered Prior Authorization Capabilities
Real-time, policy-accurate prior auth decisions across all service categories and plan types.
Real-Time Clinical Decision Support
NLP engine reads clinical notes and requests, matches against your coverage criteria in real time, and returns structured approval/denial decisions.
Explore solutionFHIR ePA API
CMS-compliant FHIR R4 prior auth API enables EMR-integrated ePA workflows, meeting 2024 Interoperability Rule requirements.
Explore solutionGold Carding Automation
AI identifies consistently compliant providers for Gold Card exemptions, reducing auth volume while maintaining appropriate utilisation management.
Explore solutionPolicy Intelligence Engine
Machine-readable coverage criteria library that auto-updates with LCD/NCD changes, keeping your auth decisions current and defensible.
Explore solutionAppeals Automation
AI-driven appeals workflow that analyses denied cases, identifies winnable appeals, and generates supporting documentation automatically.
Explore solutionPrior Auth Analytics
Approval/denial rate trends, turnaround time dashboards, policy utilisation analytics, and physician-level performance reporting.
Explore solutionPrior Auth Compliance, Fully Covered
Designed to meet current and forthcoming federal prior auth mandates.
Ready to Transform Prior Auth at Your Health Plan?
Book a 30-minute demo and see real-time prior auth decisions against live coverage criteria.