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Enterprise Layer Intelligence
Categories/Healthcare & Life Sciences/Itiliti Health
Itiliti Health

Itiliti Health

Founded 2019

Automate medical prior authorizations and communicate payer policies directly to healthcare providers

Pricing model

Demo

You can use Itiliti Health to automate prior authorization workflows between health insurance payers and medical providers. The system helps staff check whether specific procedures require prior approval and shares payer policy rules in real time. It routes authorization requests automatically, reviews medical criteria, and speeds up approval decisions. By reducing administrative phone calls and manual paperwork, organizations can lower operational overhead, avoid authorization disputes, and ensure compliance with healthcare mandates like CMS regulations while keeping patient care moving forward without unnecessary delays.

What Itiliti Health does

Verify prior authorization requirements for medical billing codesPublish payer clinical policies to clinical provider networksRoute prior authorization requests to medical review teamsAutomate clinical criteria checks on incoming medical recordsMonitor prior authorization submission metrics and call volumesTrack regulatory compliance against CMS rules and requirementsPA Checkpoint to verify whether medical procedures require prior authorizationDirect policy transparency module that communicates rules to care teamsAutomated routing of authorization requests to appropriate clinical reviewersTouchless automated approvals for submissions that meet policy criteriaCompliance support for CMS mandate standards and CRD requirementsOpen API framework for connecting to existing clinical data systemsClinical assistant tools that evaluate incoming medical documentation

Pricing breakdown

Pricing model: Book a demo

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Itiliti Health, prior authorization, PA Checkpoint, medical policy management, payer provider collaboration, touchless prior auth, CMS compliance, healthcare automation, health plan administration, clinical review routing, claims authorization, medical necessity rules, healthcare interoperability, open API healthcare, HIPAA compliant auth