Rules Engines
The rules engine is the deterministic core of Authos. It's what makes every submission explainable and defensible, not just automated.
AuthLogic
AuthLogic is the rules engine that powers every Authos submission today. It maps a payer's specific clinical criteria into a deterministic decision path: every requirement evaluated, every match recorded, every output traceable back to the policy and the source data that produced it. There's no black box — if a submission passes, you can see exactly why.
Payer Engine
AuthLogic runs on a structured store of payer-specific policy criteria — the Payer Engine. As we onboard a new payer or policy, its criteria get encoded into this store so AuthLogic can evaluate against it. Coverage grows payer by payer and policy by policy; it reflects exactly the policies we've built in, not a claim of universal coverage.
Appeals EnginePlanned
When a first submission is denied, building a defensible appeal today means starting over by hand. We plan to build an Appeals Engine to change that: a system that would construct an appeal directly from the original submission and the specific reason for denial, tied back to the same auditable evidence trail.