Prior Authorization
From intake to determination.
One platform.
Full PA lifecycle with AI-powered clinical assessment at every step. Configurable per PBM hierarchy. SLA monitoring with breach alerts.
Lifecycle
Every stage. Fully managed.
Intake
Fax, email, portal submission, and ePa (Surescripts). AI-powered document triage and auto-routing.
Questionnaire
Protocol-driven clinical questionnaires. Prescriber-facing portal with OCR pre-population.
Clinical Review
3-tier AI assessment assists clinicians. Clinical AI chat for contextual guidance.
Decision
Approve, deny, or request additional info. Determination letters with KMS encryption.
Appeal
Configurable appeal windows. Full appeal lifecycle with audit trail.
Acknowledgment
ePa response transmission. Status notifications. Complete audit history.
See the full PA lifecycle in action
See how NexusLedge embeds AI into every clinical workflow.
See the Platform