Rebuilding the Infrastructure Behind Prior Authorization

Pre Auth Health centralizes the prior authorization lifecycle into one transparent, AI-assisted workflow platform designed for modern healthcare systems.

๐Ÿ”’ Patented Technology  ยท  PHI-Free Architecture  ยท  Human-Supervised AI

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.

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

Who We Serve

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Private Clinics

Independent and specialty clinics facing mounting PA administrative workloads. Our platform gives small-to-mid-size practices enterprise-grade authorization management without enterprise complexity.

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Rural Healthcare Areas

Underserved rural communities where staff shortages make PA management especially burdensome. We bring modern infrastructure to areas that need it most.

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Skilled Nursing Facilities

SNFs managing complex, high-volume authorization workflows across diverse payer requirements. Our open-box SaaS platform scales to meet the operational demands of skilled nursing care.

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RCM Companies

Revenue cycle management companies handling Medicare prior authorization on behalf of multiple facilities and clinics. Pre Auth Health integrates into your existing workflow, reduces denial rates, and helps you deliver measurable results to your clients - all from one centralized platform.

Founders

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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 a background in project management and AI, she witnessed firsthand how prior authorization delays harm both providers and patients. As a burn and cancer survivor, she brings a deeply personal understanding of what is at stake and built Pre Auth Health to modernize healthcare infrastructure through transparent, human-centered AI.

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Leana Williams
Founder & Chief Business Officer
Pre Auth Health on LinkedIn

Leana Williams is the Founder and Chief Business Officer of Pre Auth Health, leading strategic partnerships, business development, and capital initiatives. A QuestBridge Scholar at Wesleyan University double-majoring in Economics and Psychology and a Phi Beta Kappa member, she is passionate about building solutions that improve access to care and representation in underserved communities.

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: PHI 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.