Prior Authorization, AI-Transformed
Bridge the gap between today's EHR silos and tomorrow's FHIR-mandated standards. CuraQt empowers providers to achieve instant, audit-ready authorizations through secure AI, automated redaction, and seamless EHR integration.
Healthcare providers struggle with manual processes that delay patient care and administrative workflows.
See the dramatic difference CuraQt brings to prior authorization workflows:
| Feature | Legacy Process | The CuraQt Way |
|---|---|---|
| Data Collection | Manual EHR entry & faxing | ✓ Automated FHIR & EHR API integration |
| Privacy | High risk of manual PHI exposure | ✓ ML-driven redaction + man-in-the-loop |
| Document Prep | Scattered PDFs, manual summaries | ✓ Chronological AI summaries with gap detection |
| Submission Time | 20-45 minutes per request | ✓ One-click FHIR/API submission (<5 mins) |
| Denial Management | Reactive appeals, often too late | ✓ Predictive risk scoring + AI-generated appeals |
| Compliance | Paper trails & manual spreadsheets | ✓ Instant Purge Reports & digital audit trails |
| Cost Per Request | $12-$25 in labor/errors | ✓ Under $3 through automation |
From preparation to submission, we automate every step of the prior authorization workflow.
Generates Patient summaries with intelligent identification of gaps. CuraQt uses EHR data as well as additional supporting documents.
CuraQt is set up to pull necessary data from EHRs. It also has the ability to fetch all supporting documents like Progress Notes.
Automatically identifies the Payer as well as applicable policies, criteria and rules. The platform has the capability to manage Payer data.
Built on HL7 FHIR R4 and aligned with Da Vinci Project standards (CRD, DTR, PAS). Future-proof your Prior Auth infrastructure today.
Analyzes orders and supporting evidence. Prepares detailed AI driven report on justification, evidence scoring against each applicable Payer criteria and presents recommendations to strengthen the case.
Track your approval rates and metrics. Achieve provider-level optimization with actional insights.
CMS is enforcing new interoperability requirements (CMS-0057-F) and launching pilots like WISeR to reduce waste and fraud. CuraQt ensures you're ahead of every mandate:
| 2026 CMS Requirement | The Mandate | CuraQt Capability |
|---|---|---|
| Response Times | 72 hrs (Urgent) / 7 days (Standard) | ✓ Automated tracking with SLA alerts |
| Denial Transparency | Specific, machine-readable reasons | ✓ AI Gap Analysis & Appeals Generation |
| Interoperability | FHIR-based Prior Auth API (PAS) | ✓ Provides an on-ramp and offers PAS/DTR/CRD support |
| Clinical Integrity | Maintaining data fidelity | ✓ Medical terminology protection using NER models preserving clinical context |
WISeR Pilot Alert: Starting 2026, the CMS Wasteful and Inappropriate Service Reduction (WISeR) pilot launches in AZ, NJ, OH, OK, TX, and WA. CuraQt's dual-engine architecture—Clinical Engine (Patient 360) and Regulatory Engine (CMS-0057-F)—ensures your practice handles these new scrutiny levels while maintaining clinical integrity.
Starting in 2026, high-performing providers can achieve exemptions from prior authorization entirely through "Gold Carding." CuraQt aspires to take you towards this distinction.
Monitor your approval rates and metrics in real-time. CuraQt tracks which of your physicians are approaching 95%+ approval rates—the threshold for payer exemptions. Position your practice for Gold Card status with measurable clarity.
See what percentage of your payer mix currently accepts FHIR (PAS/CRD) vs. those requiring manual/API bridges. As payers come online with FHIR, CuraQt automatically switches your volume—no migration burden, no system rebuilds.
Each denial gets a "Success Probability Score" for appeals. If an appeal has only a 10% chance of success due to hard clinical exclusions, your team won't waste time on it. Focus effort where it matters.
Built with the highest standards of data protection and regulatory compliance.
AI is not used on PHI data. Data is deidentified before handing it over to AI. On top of it, Private AI is offered as an add-on where your data never trains global models. All data remains in US-based tenants
Business Associate Agreement in place. SOC2 Type II certified Cloud infrastructure with AES-256 encryption and TLS 1.3.
ML-driven de-identification using NER (Named Entity Recognition). Man-in-the-loop review for 100% HIPAA confidence.
Hard Purge feature wipes all patient data post-authorization. Compliance Purge Reports generated for auditors.
Complete digital audit trails for every action. Full transparency for internal compliance reviews.
Built on HL7 FHIR R4. Compliant with Da Vinci Implementation Guides (CRD, DTR, PAS).
CuraQt delivers exceptional ROI. Here's what you get for your investment and why CuraQt plans offer exceptional value.
CuraQt reduces manual PA processing from $20-30 to under $3 per request. On a 500-request/month practice, that's $102K-$162K annually.
📊 Sources:
• CAQH 2024 Index Report
• AMA 2024 Physician Survey
Non-compliance with 2026 CMS-0057-F mandates costs: denial of meaningful use incentives, CMS audits/penalties, retraining.
CuraQt's value: Automated compliance + audit trails minimizes risk .
Physicians achieving 95%+ approval rates gain exemptions from prior authorization. One exempted physician eliminates 60-80% of PA administrative work.
CuraQt's Gold Card Readiness Score: Tracks path to exemptions. 10-physician system = $300K-$600K annual value.
Many providers fear the FHIR transition will require costly EHR overhauls. CuraQt's FHIR bridge and readiness dashboard enables a smooth transition with your existing systems.
Result: Stay competitive without expensive system replacements.
Appeal Success Probability Scoring prevents wasted effort on low-win appeals. Staff focus on high-impact work, reducing burnout and improving retention.
Indirect value: Reduced turnover, better staff morale, improved physician satisfaction.
CuraQt's man-in-the-loop AI means physicians, not algorithms, make final decisions. This unique approach ensures clinical judgment is preserved while administrative burden disappears.
Competitive advantage: Physicians prefer CuraQt because they stay in control.
Disclaimer: ROI projections based on published healthcare industry research from CAQH, AMA, and CMS. Individual results vary based on practice size, specialty, and current workflows. For a custom analysis specific to your organization, contact us.
Get answers to common questions about security, compliance, and clinical integration.
Absolutely. We use Reversible De-Identification. Before any AI analysis occurs, our system redacts PHI while preserving medical terminology. You maintain "Human-in-the-Loop" control to reverse redactions for final verification, ensuring HIPAA compliance and clinical accuracy.
Not at all. CuraQt is an "AI Assistant." It organizes evidence and highlights payer rules so you can make the final call faster. You remain the clinical authority; we just remove the administrative friction.
When a payer changes their criteria for a procedure or medication, CuraQt updates its "Gap Detection" engine, ensuring you always have the latest requirements. As and when Payers are CMS-0057-F ready, CuraQt will use it's "CMS-PA" engine to seamlessly integrate with Payer systems.
CuraQt is built natively for the new 2026 mandates, and offers an "On-Ramp" where Providers can leverage it as a bridge to comply with full audit trails.
Yes. CuraQt supports FHIR and legacy integrations like HL7. We serve as your "FHIR bridge" for legacy systems.
With our "Hard Purge" feature, all patient data is automatically wiped from the CuraQt environment upon completion. We generate a "Compliance Purge Report" for your internal auditors—proving zero data persistence.
Join healthcare providers who have reduced administrative burden and improved patient outcomes with CuraQt.
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