Transform Your Prior Authorization Process with AI
AI-powered system that analyzes medical policies, validates clinical evidence, and optimizes Prior Authorization letters for maximum approval probability. Built for providers, powered by transparent AI, designed for results.
We're on a mission to eliminate administrative burden in healthcare, starting with the most painful process: prior authorization. Our multi-agent AI system helps providers get approvals faster while improving patient outcomes.
Our Mission
To eliminate the administrative burden of prior authorization, allowing healthcare providers to focus on what matters most: patient care.
Every year, providers spend millions of hours navigating PA requirements. We're building AI that understands medical policies, clinical evidence, and payer requirements to make this process instant and accurate.
Our Vision
A healthcare system where administrative processes are automated, transparent, and patient-centered.
We envision a future where PA decisions happen in real-time, based on clinical evidence and current medical guidelines, with full transparency for providers and patients.
Streamline Submission and Maximize Approval with Adjudicator AI products
Our AI-powered platform accelerates your team with transparent reasoning at every step. Working as your intelligent partner, Adjudicator analyzes policies, validates clinical evidence, and optimizes Prior Authorization submissions—always with human reviewers in the loop to ensure quality and maximize approval probability.
Policy Analysis
PolicyAnalystPolicyAnalyst agent extracts medical policy requirements, clinical criteria, and documentation needs from LCD/NCD and commercial payer policies.
Quality Control
QualityControlQualityControl agent validates clinical evidence against policy criteria, identifies gaps, and calculates acceptance probability score.
Letter Optimization
EditorEditor agent refines language for maximum approval probability, ensuring medical necessity is clearly articulated with supporting evidence.
Human Review
Provider reviews AI-generated letter with transparent reasoning, acceptance probability, and suggested improvements before submission.
Submission
Final PA letter is submitted to payer with complete documentation, clinical evidence, and policy citations.
Why Adjudicator Wins
The only PA automation platform with transparent AI reasoning, human-in-the-loop quality control, and real-time probability scoring.
Multi-Agent AI Architecture
Unlike black-box AI solutions, Adjudicator uses three specialized AI agents that collaborate to analyze medical policies, generate evidence-based PA letters, and ensure quality before submission. Each agent has a specific role with transparent reasoning.
Transparent AI Reasoning
Every AI-generated recommendation includes detailed reasoning, policy citations, and confidence scores. No more wondering why the AI suggested specific language or clinical evidence.
Quality Control Focus
Adjudicator prioritizes PA letter quality over processing speed. Our QualityControl agent validates every letter against medical policy requirements, clinical evidence standards, and historical approval patterns before submission.
Acceptance Probability Scoring
Machine learning model predicts PA approval probability based on clinical evidence, medical policy criteria, payer patterns, and historical data. Focus your effort where it matters most.
FHIR Prior Auth API Ready
Adjudicator is actively preparing for the CMS FHIR Prior Authorization API mandate. Our roadmap includes full FHIR R4 compliance, payer connectivity, and real-time status updates.
EHR Integration
Integrate with major EHR systems to automatically pull patient demographics, diagnosis codes, medications, lab results, and clinical notes for PA letter generation.
Approval Rate
Time Savings
Transparency Score
Ready to Get Started?
Ready to streamline your Prior Authorization process? Get in touch with our team.