PriorAuthIQ — AI prior authorization and explainable no-show prediction for independent clinics
Your front desk is on hold with Aetna right now.
PriorAuthIQ drafts prior authorizations in seconds and predicts which appointments will no-show — before they do.
Stop paying the tax on payer phone trees and empty chairs.
Drafts that survive payer scrutiny — in seconds.
PriorAuthIQ pulls clinical context from the chart, picks the right CPT/ICD pair, and assembles a payer-specific packet that meets medical-necessity criteria. Your staff stops re-typing the same lumbar MRI justification fifty times a week.
Predict empty chairs before they cost you $200.
A risk score on every appointment 48 hours out — based on history, lead time, payer mix, and weather. We auto-trigger tiered outreach (text, voice, rebook offer) so the slot fills before the gap appears in your schedule.
What's new in PriorAuthIQ
Six upgrades landed this quarter — all included in every plan.
Explainable no-show ML
Per-clinic logistic regression with SHAP-style top factors on every prediction.
Revenue-at-Risk meter
Live 7-day dollar exposure with projected save from your intervention tiers.
Gold-card auto-discovery
We flag CPT × payer combos where your approval rate qualifies for gold-card status.
Pre-visit PA auto-initiation
Drafts start 72 hours before the visit for any CPT that historically requires auth.
Waitlist auto-fill
High-risk slots get rescue offers to matched waitlist patients, before they empty.
Search Console integration
SEO metrics from Google Search Console land directly in your admin dashboard.
Six things Cohere, Rhyme, and Availity don't do.
Enterprise-grade automation without the enterprise contract. Every feature below is live for Clinic-tier subscribers or above.
How the no-call no-show prediction actually works
No black box, no data leaving your clinic. A transparent per-clinic model, calibrated to real probabilities, with a "Why?" panel on every prediction.
The signals it looks at
Eleven engineered features across four groups. All computed from your own appointments and noshow_events — no third-party enrichment, no external ML API call.
The model
L2-regularized logistic regression implemented in pure TypeScript. Trained per-clinic on your own historical outcomes. Runs entirely inside your Lovable Cloud project — the model weights are the only thing that leaves the row.
For new clinics with fewer than 200 completed visits, we bootstrap with a cold-start prior derived from a de-identified multi-clinic average, then blend towards your data as it grows.
Isotonic calibration
Raw logistic scores are calibrated so probabilities map to actual frequencies. When the model says 42%, 42% of those appointments really no-show. That's what makes the dollar-weighted "Revenue-at-Risk" meter meaningful.
Every prediction ships with a "Why?"
Front-desk staff click Why? on any appointment and see the signed contribution of every feature — positive factors push risk up, negative factors pull it down. Same explanation the model used, not a plausible-sounding rewrite.
This is SHAP-style attribution over the calibrated logistic model — mathematically consistent, so the contributions actually sum to the prediction.
Proof it works
Live self-test — retrains on 2,000 synthetic appointments, evaluates on 800 held out. Runs in your browser session right now.
A perfectly calibrated model sits on the dashed diagonal. Our curve tracks it closely because of isotonic post-training calibration.
Closing the loop
A prediction alone doesn't save the visit. Each score maps to a tiered intervention with a defined cost — so you only spend expensive outreach on high-risk slots.
Reminder SMS
Single SMS confirmation 24h before the slot.
Multi-touch outreach
SMS + WhatsApp + email cadence at 72h, 24h, 2h.
Live call + double-book
Voice-agent confirmation 48h out; auto double-book the slot if no confirm by 24h.
How much is your clinic losing?
Clinics who stopped subsidizing payer inefficiency.
"We reclaimed an entire FTE. My MA used to spend Tuesday and Thursday on hold with payers — now she's actually rooming patients."
"Our no-show rate dropped from 22% to 9% in the first quarter. The risk-scored schedule is the first thing I open every morning."
"I expected the PA drafts to be 70% there. They're 95% there. I sign, I send. That's the workflow now."
Pay only for what you submit.
One credit = one automated payer action. No seats, no per-provider surcharge, no surprise overages. Bulk packs lower your cost per check, and Auto-Top-Up keeps high-volume clinics running 24/7.
- 1 provider
- No PA success fee
- Community
- No PA success fee
- Explainable no-show ML
- FHIR PAS sandbox
- 1 provider
- $9 per approved PA
- Everything in Free
- Denial Shield™ credit-back
- Priority PA drafting
- Up to 5 providers
- $6 per approved PA
- Priority + Slack
- Gold-Card auto-enroll
- Payer Turnaround Radar
- Zero-touch Peer-to-Peer scheduler
- Up to 20 providers
- $4 per approved PA
- Dedicated CSM
- Multi-location rollups
- Custom playbooks
- Advanced drift monitoring
- Unlimited
- $2 per approved PA
- Dedicated CSM + SLA
- BAA + HITRUST roadmap
- SSO / SAML
- Custom FHIR endpoints
Every claim below is sourced. Hover any cell for the evidence.
- Base price
- Per approved PA
- Denial refund
- Gold-card auto-file
- Turnaround Radar
- FHIR PAS
- Contract
- Base price
- Per approved PA
- Denial refund
- Gold-card auto-file
- Turnaround Radar
- FHIR PAS
- Contract
- Base price
- Per approved PA
- Denial refund
- Gold-card auto-file
- Turnaround Radar
- FHIR PAS
- Contract
- Base price
- Per approved PA
- Denial refund
- Gold-card auto-file
- Turnaround Radar
- FHIR PAS
- Contract
- Base price
- Per approved PA
- Denial refund
- Gold-card auto-file
- Turnaround Radar
- FHIR PAS
- Contract
Competitor figures are compiled from vendor pricing pages, product docs, G2 reviews, and public analyst commentary. Last reviewed 2026-Q1. Vendors: email research@priorauthiq.com to submit corrections and we will update within 5 business days.
- Eligibility check1 cr
- Pre-Auth submission (AI draft + submit)5 cr
- AI-drafted appeal letter3 cr
- Voice agent payer call10 cr
- Patient portal SMS/email1 cr
Credits are deducted from your wallet before the call to the payer or clearinghouse is made — so a failed insurer API never leaves your books out of sync.
- Credits never expire
- Unlimited users + locations
- Auto-Top-Up when you run low
- Credits never expire
- Unlimited users + locations
- Auto-Top-Up when you run low
- Credits never expire
- Unlimited users + locations
- Auto-Top-Up when you run low
- Credits never expire
- Unlimited users + locations
- Auto-Top-Up when you run low
- Credits never expire
- Unlimited users + locations
- Auto-Top-Up when you run low
New clinics start with 25 free Auth Credits — enough to run your first eligibility checks and pre-auths on us.