Rebuilding the Infrastructure Behind Prior Authorization

Your patient data stays with you. All clinical information is stored in your encrypted Azure environment and never sent to our AI. The AI receives only structured denial codes and CMS guidelines.

HIPAA-Aligned Architecture Microsoft Azure Secured Zero-PHI AI Design
Who We Serve
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Skilled Nursing Facilities
Complex, high-volume PA workflows across diverse payer requirements
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Private Clinics
Enterprise-grade authorization management without the complexity
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RCM Companies
Centralized PA management across multiple facilities and clients
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Rural Healthcare
Modern infrastructure for underserved communities with staff shortages

Who We Serve

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Skilled Nursing Facilities

High-volume, complex PA workflows across multiple payers and care levels. Pre Auth Health gives your billing team a single place to manage every authorization from submission to appeal.

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Independent Clinics

Enterprise-grade prior authorization management without the enterprise price tag. Built for small teams where one person handles billing, tracking, and appeals all at once.

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RCM Companies

Manage prior authorizations across multiple facilities and clients under one subscription. Centralized tracking, denial patterns, and appeal generation across your entire book of business.

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Rural Healthcare

Rural clinics and SNFs face the highest administrative burden with the fewest resources. Pre Auth Health is self-service, affordable, and requires no IT team. Built for communities that cannot afford to lose a single reimbursement to a preventable denial.

Fragmented Systems. Delayed Care. Administrative Burden.

53M+
Prior authorization requests submitted annually in Medicare Advantage markets
4M+
Denials issued each year across Medicare Advantage plans
Only 7%
Of denials are ever appealed by patients or providers
~80%
Of those appeals are overturned, revealing systemic flaws in initial reviews
Pre Auth Health is initially focused on modernizing Medicare Advantage prior authorization workflows, with scalable open-box SaaS infrastructure designed for broader healthcare markets.
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New CMS Requirement, Effective March 31, 2026: Medicare Advantage plans, Marketplace plans, Medicaid, and CHIP managed care are now required to publicly report prior authorization denial rates, appeal overturn rates, and decision timelines annually. For SNFs, private clinics, and RCM companies, your PA workflow is no longer just an operational issue. It is a compliance and transparency issue. Pre Auth Health is built to help you meet this moment.

Simple, Transparent Pricing

โœ… All plans include a 14-day free trial. No charge until your trial ends.
Starter
$149/mo
Starting price
Best for independent practices and low-volume workflows getting started with PA management.
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Growth
$399/mo
Starting price
Best for mid-size clinics and small SNFs that need AI-assisted appeals and advanced tracking.
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RCM Flat
$699/mo
Starting price
Best for RCM companies and large SNFs needing multi-facility management across unlimited clinics.
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All plans are set up with hands-on onboarding. Schedule a demo to get started.

Prior Authorization, Managed End-to-End

1
Patient
2
Documentation
3
Policy Matching
AI-Assisted
4
Submission
via Fax
5
Tracking
6
Denial Mgmt
7
Appeal Gen
8
Patient Notification
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Full-Cycle Visibility

Complete authorization lifecycle managed in one unified dashboard

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AI-Assisted, Staff-Reviewed

AI-assisted documentation support, with every step reviewed and overseen by your staff

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Fax-Based Submission

Seamless fax submission supporting existing payer workflows and requirements

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Enterprise Scale

Open-box SaaS designed for high-volume healthcare operations and growth

Reducing Administrative Friction. Supporting Patient Care.

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Protects Clinician Time

Streamlined workflows reduce administrative overhead for care teams

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Reduces Avoidable Delays

Accelerated processing supports timely access to care

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Improves Transparency

Real-time visibility into authorization status and outcomes

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Strengthens Appeals

Comprehensive documentation supports successful appeal outcomes

See It In Action

See how Pre Auth Health manages the full prior authorization lifecycle from submission to appeal in under two minutes.

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Built by Someone Who Knows the System

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Valerie Williams
Founder & Chief Executive Officer
Connect on LinkedIn

Valerie Williams is the Founder and CEO of Pre Auth Health. With experience on both the payer and provider side of Medicare Advantage, she understands what breaks the system from every angle. As a patient herself, she built Pre Auth Health because she knows what is at stake when the infrastructure fails.

Building Modern Infrastructure for Prior Authorization

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Active Deployment

Platform live and delivering results for healthcare partners across our service areas

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Strategic Partners

Expanding partnerships with clinics, SNFs, and rural health systems

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Early-Stage Capital

Raising seed investment round to accelerate growth

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Scalable Roadmap

Open-box SaaS architecture built for enterprise deployment

Contact Us for Partnership or Investment Opportunities

Insights & Resources

Founder Perspective

It's Not What You Do. It's How. Why I Built AI Into a Healthcare Platform, and Why I Almost Didn't

I've taken over 10,000 Medicare Advantage calls. I know what it sounds like when a patient finds out their procedure was denied. The problem was never prior authorizations themselves. It was that nobody built a system that made them work the way they were supposed to. So I built one. But first I had to solve two things that terrify me about AI in healthcare: patient data exposure and hallucinations.

Compliance Update

What the 2026 CMS Prior Authorization Transparency Rule Means for RCMs and SNFs

As of March 31, 2026, CMS now requires Medicare Advantage plans to publicly report prior authorization denial rates, appeal overturn rates, and decision timelines every year. For RCM companies and skilled nursing facilities, this is not just a policy update. It is a direct signal that your prior authorization workflow will face increased scrutiny. Here is what you need to know and how to prepare.

Industry Data

Why 80% of Medicare Prior Auth Appeals Are Overturned, and What That Tells Us About the System

Only 7% of Medicare prior authorization denials are ever appealed. Of those, roughly 80% are overturned. That means the vast majority of denied claims that get challenged are found to be wrong. This is not a patient problem or a provider problem. It is a systemic infrastructure problem, and it is exactly the problem Pre Auth Health was built to solve.

Get in Touch

Interested in learning more about Pre Auth Health? Reach out to discuss how our platform can support your organization, explore partnership opportunities, or connect with our investment team.

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