For Payers

Smarter Authorization, Faster Decisions

Process PA requests faster and more accurately. ParaHealth helps payers reduce manual review while improving provider satisfaction.

PA Review Queue
0 / 6
PA-8841Jones, S.
Humira 40mg
PA-8842Kim, D.
Ozempic 1mg
PA-8843Chen, M.
Jardiance 10mg
PA-8844Garcia, R.
Dupixent 300mg
PA-8845Patel, A.
Eliquis 5mg
PA-8846Williams, T.
Keytruda 200mg
Processing queue...

The Payer Challenge

Volume is growing. Staff is stretched. Providers are frustrated.

Millions/yr
PA Requests

Payers process millions of PA requests annually, straining operational resources and driving up admin costs.

45%
Incomplete Submissions

Nearly half of PA submissions arrive with missing or insufficient clinical documentation, requiring costly back-and-forth.

High
Provider Friction

Complex PA requirements create friction with providers and impact network satisfaction and retention.

80% of Requests Never Touch a Reviewer

Routine PA requests that meet clinical criteria are auto-resolved in under a second. Your team only sees the cases that actually need human judgment — complex oncology, specialty drugs, incomplete documentation.

  • Routine requests auto-approved against your coverage policies
  • Only exceptions and edge cases escalated to clinical reviewers
  • Consistent policy application across every single request
Intelligent Triage
0 of 5 sorted
PA-9901Metformin 500mg
First-line therapy
PA-9902Humira 40mg
Step therapy met
PA-9903Keytruda 200mg
Oncology — manual
PA-9904Ozempic 1mg
BMI + A1c criteria
PA-9905Dupixent 300mg
Missing prior tx docs
Sorting...

Complete Submissions, Not Incomplete Faxes

When providers use ParaHealth, their submissions arrive pre-validated with all required documentation attached. No more back-and-forth requests for missing labs, incomplete step therapy records, or wrong ICD-10 codes.

  • Submission completeness jumps from 55% to 98%
  • Providers are guided to include everything your policy requires
  • Fewer return-to-provider cycles saves your ops team thousands of hours
Submission Completeness
BeforeWith ParaHealth
Clinical documentation
55%
98%
ICD-10 specificity
62%
99%
Step therapy evidence
40%
95%
Lab results attached
48%
97%

Providers Stop Calling to Complain

When turnaround drops from days to hours and submissions stop bouncing back, provider friction disappears. Better PA experience means better network satisfaction and fewer support calls.

  • Average turnaround drops from 3.2 days to 4 hours
  • Provider support calls drop 83% — your team handles real issues
  • Network satisfaction scores improve measurably
Provider Experience Impact
Avg. turnaround time
3.2 days4.1 hours
-97%
Incomplete submission rate
45%8%
-82%
Provider support calls
12K/mo2.1K/mo
-83%
Network satisfaction score
61/10089/100
+46%

How It Works

From intake to decision in minutes, not days.

1

Receive PA

Structured request arrives with complete documentation

2

AI Triage

Automated clinical criteria matching and risk scoring

3

Flag Issues

Incomplete items flagged, routine requests auto-resolved

4

Decision

Approve, request info, or escalate to medical director

5

Notify

Instant provider notification with decision details

Measurable Impact

Results from day one.

0%
Faster Processing
0%
Fewer Incomplete Submissions
0%
Less Manual Review

Ready to Modernize Your PA Process?

See how ParaHealth can reduce your review burden and improve provider relationships