AIPrism reads your clinical documentation against payer policy and drafts prior-authorization requests and denial-risk assessments for orthopedic procedures. Every draft is unreviewed until a licensed clinician approves, edits, or rejects it — with a full immutable audit trail.
Not a black-box auto-approver. A clinician-supervised drafting assistant with full provenance.
Patient J.M. · Meridian Health Plan · CPT 63650 · Requested 2026-07-24
AIPrism ingests the clinical note, imaging report, and any prior conservative-care history for the case.
The model reads the documentation against the specific payer policy and drafts the PA with a denial-risk assessment.
A licensed clinician is always the decision-maker. Nothing leaves AIPrism until they say so.
Every draft, edit, approval, and rejection is recorded with actor, timestamp, and content — tamper-evident by design.
AIPrism drafts each PA request and flags the specific policy criteria most likely to trigger denial, with citations.
A single prioritized queue sorts pending cases by risk and wait time, so the highest-stakes work surfaces first.
Every state change is captured with actor and timestamp. Entries cannot be edited or deleted through the UI.
Clinician turnaround, edit rate, rejection rate, and risk concentration by payer — live from case state.
Roadmap for SMART on FHIR launch and Coverage/Claim/Condition mapping into the Case model.
Focused on orthopedic procedures — knee arthroscopy, SCS implants, tissue grafts, lumbar MRI — before we go broad.
AIPrism is early-stage. Our SOC 2 and HIPAA compliance program is underway — no audit has been completed yet, and we will not describe AIPrism as SOC 2 certified, SOC 2 compliant, or HIPAA compliant until it is. This section is a roadmap, not a badge wall.
What is real today: an immutable audit trail on every case, and a product designed around a licensed clinician as the decision-maker.
Every draft, edit, approval, and rejection is captured with actor and timestamp, and cannot be modified through the product surface.
TLS 1.2+ in transit and provider-managed encryption at rest, with a full key-management review underway.
Role-based access controls with SAML/OIDC single sign-on for practice and health-system deployments.
A signed Business Associate Agreement (and DPA where applicable) is a hard gate before any real patient data is processed.
Controls are being built to be audit-ready. No certificate has been issued yet — and we will not claim one until it has.
We work with a small number of design partners at a time. Tell us about your practice and the procedures where prior auth is the biggest drag today, and we'll be in touch.