AI-Powered Prior Authorization

Know the answer before you submit

GetPreAuth reviews your clinical documentation against insurance guidelines in seconds — telling you if a prior auth will be approved, denied, or what's missing before you ever contact the insurance company.

Get Started Free → See how it works ↓

30sec

Average review time

900+

CPT codes covered

49%

Requests approved on first submission

Guideline matched — Evolent 7283

✅

Molina Medicaid · CPT 75625

Approved

Patient meets criteria: Disabling claudication despite 6+ months optimal medical therapy. Duplex ultrasound confirms bilateral aortoiliac stenosis >70% with ABI 0.52. Intent to intervene documented.

Case PA-2026-0507-0124 23 seconds

Save case number for insurance submission

The Problem

Prior auth is broken.
We fix it.

Every day, physicians and billing teams waste hours guessing whether a prior authorization will be approved — often submitting incomplete requests that get denied.

16%

Of medical claims are denied

The average practice loses tens of thousands of dollars annually to preventable denials — most caused by missing documentation or unmet criteria.

2hrs

Spent per authorization request

Staff spend hours researching payer guidelines, checking criteria, and assembling documentation — time that should be spent on patient care.

40%

Of denials are never appealed

Most denied claims are never appealed because practices don't know the exact criteria that was missed. GetPreAuth tells you exactly what to fix.

How It Works

From submission
to answer in seconds

Enter the request

Select the insurance plan and enter the CPT procedure codes being requested. The app automatically identifies the correct guideline source.

Upload clinical notes

Upload or paste your office notes, test reports, and supporting documentation. Patient identifying information is automatically removed before anything leaves your computer.

Review against guidelines

Our AI checks your documentation against the exact coverage criteria — NCD, LCD, and payer-specific guidelines — following the correct hierarchy for each insurance type.

Get a clear answer

Receive an immediate determination: Approved, Not Approvable, or exactly which documents are missing — with a case reference number for your records.

Features

Everything you need
to get prior auths right

🏥

Full Insurance Hierarchy

For Medicare, the app automatically checks National Coverage Determinations (NCD) first, then Local Coverage Determinations (LCD) by state, then plan-specific guidelines. No manual lookup required.

Medicare · Medicaid · Commercial · Exchange

📋

900+ Procedures Covered

Cardiology, vascular, orthopedic, imaging, radiation oncology, sleep studies, genetic testing, and more. Evolent, Evicore, AIM Specialty, and CMS guidelines — all indexed and current.

Evolent · Evicore · AIM · CMS NCD/LCD

🔒

HIPAA-Safe by Design

Patient identifying information is automatically redacted in your browser before any document leaves your computer. Names, dates, MRNs, and addresses are stripped before AI review.

PHI Redaction · Encrypted Transit

⚡

Specific, Actionable Feedback

When documentation is missing, the app tells you exactly what to submit — not vague guidance. "Submit duplex ultrasound report with vein diameter measurements" not "submit additional documentation."

Not Approvable · Action Required · Approved

Denial Analysis

Turn denials into
approved claims

When insurance denies a request that should have been approved, GetPreAuth helps you understand exactly why and what to do next.

🔍

Identify the gap

Submit the denied claim to GetPreAuth. The app compares your documentation against the exact guideline criteria and identifies which specific requirement was not met.

📝

Know what to fix

The app tells you exactly what's missing — "vein diameter documented at 3mm, guideline requires 5mm or greater" — so you know precisely what additional documentation to gather.

📤

Resubmit with confidence

Add the missing documents, rerun the review, and confirm approval before resubmitting to insurance. Stop guessing and start winning more appeals.

75%

of properly appealed denials are overturned

Exact criteria comparison — what you submitted vs. what's required
Specific measurement gaps (e.g. vein size, ejection fraction)
Time interval requirements (e.g. study done too recently)
Missing required reports identified by name
Re-run reviews after adding documents — no new request needed
Case reference numbers for tracking submissions

Pricing

Simple, transparent pricing

No hidden fees. No per-review charges. Flat monthly rate so you can run as many reviews as your practice needs.

Solo Practice

^$99

per month

Unlimited reviews
1 user account
All 900+ CPT codes
All insurance types
PHI redaction
Case history

Get Started

Know the answer before you submit

Prior auth is broken.We fix it.

From submissionto answer in seconds

Everything you needto get prior auths right

Turn denials intoapproved claims

Simple, transparent pricing

Ready to stop guessingon prior auths?

Prior auth is broken.
We fix it.

From submission
to answer in seconds

Everything you need
to get prior auths right

Turn denials into
approved claims

Ready to stop guessing
on prior auths?