Prior Authorization
Klevera Prior-authorization
Automate prior authorization triage with clinical evidence synthesis, reducing approval cycle times from days to minutes — while keeping every determination defensible.
Capabilities
- Clinical evidence automation
- Real-time authorization triage
- Payer protocol compliance
- Appeals management
- CMS-0057 aligned workflows
- Reviewer-ready rationale with citations
Evidence assembled before review
Klevera reads the request, attachments, and patient history, then assembles the clinical evidence against the applicable policy criteria so reviewers open a complete, structured case rather than a document pile.
Straight-through where it is safe
Clear approvals route straight through under your configured guardrails; ambiguous or high-impact cases escalate to clinicians with the exact criteria in question highlighted.
Built for appeals
Each determination stores the criteria version, evidence used, and rationale, so an appeal months or years later can be answered from the record itself.