Everything you need to know about how Pre Auth Health works, what it does, and how it protects your organization.
Compliance and Security
Yes. Pre Auth Health is fully HIPAA compliant. The platform is designed with compliance as its foundation - not an afterthought. All prior authorization records are stored for 10 years to support claw-back protection and audit requirements. Your organization has the documentation it needs if a payer or CMS audits past authorizations years after the fact.
10-year record storage is built in by default - no configuration required.
No. Patient health information never enters the AI. The AI receives only the denial reason and the relevant CMS guideline. PHI stays entirely within your staff's workflow. This is not a policy - it is a structural design decision built into the platform architecture by design. It is structurally impossible for PHI to cross into the AI layer.
PHI-free AI is not a setting you turn on. It is how the platform is built.
How It Works
Pre Auth Health supports fax-based submission and PA packet export, which works seamlessly with existing payer workflows and requirements. Your staff completes the authorization through the guided platform workflow and submits via fax or exports a complete PA packet. No payer portal login required. The platform uses payer-specific prior authorization forms to ensure submissions meet each payer's requirements.
Pre Auth Health manages the full denial and appeal process. When a denial comes through, the platform generates an appeal argument grounded in the specific CMS guideline relevant to the denial reason. A staff member reviews and connects that argument to the patient record before submission. Every step is tracked and documented. The AI handles pattern recognition. The human makes the final call.
Only 7% of Medicare prior auth denials are ever appealed - yet 80% of those appeals are overturned. Pre Auth Health makes appealing the default, not the exception.
Yes. Patient notification is built into the standard workflow. When authorization decisions are made, the platform supports notifying patients as part of the process - keeping patients informed without adding manual steps for your staff.
Deadline tracking is built into the full authorization lifecycle. The platform monitors where each prior authorization is in the process and surfaces pending deadlines so nothing falls through the cracks. Every authorization in flight is visible from one centralized dashboard.
Who It Is For
Pre Auth Health is built for skilled nursing facilities, private clinics, rural healthcare providers, and RCM companies managing Medicare prior authorization workflows. It is designed to handle high-volume, multi-payer environments where documentation accuracy, deadline tracking, and denial management are operationally critical.
Pre Auth Health manages the complete Medicare prior authorization lifecycle in one platform - from guided submission and deadline tracking through denial management, AI-assisted appeal generation, and patient notification. Key differentiators:
- PHI-free AI architecture built by a cybersecurity professional
- Human supervision at every step - the AI supports, staff decides
- Self-teaching platform that improves with use
- 10-year compliance storage for claw-back protection
- Built specifically for Medicare Advantage workflows, not adapted from general billing tools
Getting Started
Pre Auth Health is now onboarding SNFs, private clinics, and RCM companies. Fill out the contact form at preauthhealth.com to schedule a demo, ask about how the platform fits your workflow, or discuss a partnership opportunity.
We work closely with each new partner to ensure a smooth onboarding — your team gets direct support from our team from day one.
Pre Auth Health is designed so staff submits correctly from day one - no lengthy training calls or implementation manuals required. The guided workflow walks staff through each step of the prior authorization process, which means your team can start submitting accurately from the first authorization.
Still Have Questions?
Reach out directly and our team will get back to you. We are happy to walk through how Pre Auth Health fits your specific workflow.