Every authorization arrives built,
checked, and cited.
AuthLogic pulls the case from your EHR, evaluates it against the payer's published policy, and shows the paragraph behind every requirement. Your staff review and submit.
Prior authorization takes a practice about 13 hours a week per physician. We are building to take that under an hour.
Prior authorization, by the numbers
A prospective multicenter study of 2,225 anti‑VEGF authorization requests across US retina practices measured what a single case takes, where it gets stuck, and how often it comes back around.
median staff time spent on a single prior authorization
- 76%
- of denials were for step therapy
- 64%
- of authorizations were reauthorizations
- 59.6%
- of approvals still delayed care by more than 24 hours
A case walks in. A finished authorization walks out.
The case arrives
An injection order in your EHR is the trigger. Nobody types a patient into a second system.
Evidence gets assembled
The facts that decide an authorization are not in structured fields. Prior therapy sits in note prose, measurements in a device PDF. AuthLogic reads the unstructured record.
The payer's policy gets applied
Not a generic checklist. The criteria this payer published for this drug on this plan, under the effective date they published it.
The verdict
Ready, or blocked with the exact requirement that is missing and what would clear it. The fix takes a minute instead of an afternoon.
Your staff submit
The case is assembled and validated before anyone opens it. A person reviews it and sends it. That step stays human on purpose.
The outcome trains the next case
Every outcome links back to the criteria applied to it, which makes it training data rather than a log line. The system learns which arguments clear which payers.
Every requirement points at the policy it came from.
Criteria come out of the payer's own published document with the paragraph and the effective date attached. When a payer revises a threshold, the criterion changes because the document changed, not because enough denials piled up to reveal it.
This matters more every year. Under CMS-0057-F, payers now have to give a specific reason when they deny. A tool that can point to the exact criterion and the exact paragraph can answer that reason. A tool that learned a pattern cannot.
Every case is auditable
Open any authorization and read the full history of what was checked, what was missing, who resolved it, and when.
Nothing is silently overwritten
Case history is append-only. A case that was blocked and then resolved does not read as though it was always fine.
The rules are inspectable
You can read the criteria AuthLogic is applying and the source document it read them from.
Built for ophthalmology, starting with retina.
Anti-VEGF is where we started because it is the highest-volume authorization in the specialty and the one with the most at stake when it is late. If you run authorizations for an ophthalmology practice, we want to hear how your queue actually works.