Powered by Clinical Intelligence

Prior Authorization
Without the Burden

PayorIQ uses clinical intelligence to build medically-necessary, payer-specific prior authorization packages that get approved the first time. Purpose-built for Oncology and Orthopedics practices.

94%
First-pass approval rate
<2 min
Package generation time
68%
Reduction in admin hours

Built for High-Complexity Specialties

Prior authorization requirements vary dramatically by specialty and payer. PayorIQ is trained on the clinical criteria that matter for your practice.

Oncology

Chemotherapy regimens, immunotherapy, radiation therapy, genomic testing, and supportive care authorizations.

  • NCCN guideline-aligned clinical justification
  • Payer-specific formulary and step-therapy awareness
  • Line-of-therapy documentation with progression evidence
  • Genomic biomarker and companion diagnostic mapping

Orthopedics

Joint replacements, spinal procedures, advanced imaging, DME, and post-surgical rehabilitation authorizations.

  • Conservative therapy documentation trail
  • Functional limitation scoring with objective measures
  • Surgical necessity criteria matched to payer LCD/NCD
  • Post-operative rehab justification with outcome benchmarks

How It Works

From chart to approved authorization in minutes, not days.

01

Ingest Clinical Records

Upload the patient chart — progress notes, labs, imaging, prior treatments. PayorIQ extracts structured clinical data automatically.

02

Match Payer Criteria

The engine identifies the relevant payer, plan, LCD/NCD policies, formulary requirements, and step-therapy protocols for the requested service.

03

Generate PA Package

A complete, submission-ready authorization package is assembled with clinical justification mapped point-by-point to payer requirements.

04

Submit & Track

Submit electronically or via fax with full audit trail. Track status, respond to additional information requests, and manage appeals if needed.

Why Practices Choose PayorIQ

Reduce Denials

Clinical justification is mapped to payer-specific criteria before submission, catching gaps that cause denials.

Eliminate Phone Trees

No more hours on hold with payer reps. Submissions go out complete and audit-ready the first time.

Reclaim Staff Time

Your team focuses on patient care while PayorIQ handles the payer documentation burden.

Full Audit Trail

Every submission is documented with clinical reasoning, payer criteria match, and regulatory compliance records.

Ready to Eliminate the Prior Auth Bottleneck?

See how PayorIQ can reduce your denial rate and give your staff hours back every week. Schedule a 20-minute demo with our team.

Schedule a Demo

info@cloudanalytics.ai