Prior authorization,
Approvals faster, with less staff time. One source-grounded workflow, no EHR integration.
See it on your toughest case.
Bring a denied or tricky prior auth (de-identified). We'll show you the payer criteria and the evidence behind it, live.
No spam, ever.
One workflow. Every payer step.
This is the actual interface. Six tools that take a prior auth from requirements lookup to cited appeal, in one place. Click through them below.
Grounded in real policy.
Not guesswork.
Prior-auth knowledge is scattered across thousands of payer policies, clinical studies, and shifting state and federal rules. Praxigen continuously maps them into one queryable layer, so every answer is retrieved from a cited source, never invented.
Every answer is traceable
Each recommendation links back to the payer policy, regulation, or study it came from. No black box.
It stays current
Automated jobs watch the Federal Register and payer policies, so requirement changes are caught, not missed.
No fabrication
Evidence comes from real, cited studies and published policy. If a source does not support it, we do not claim it.
Everything prior auth takes, in one place.
Lookup, note-checking, appeals, pre-claim checks, and analytics. One workflow, no tab-juggling across payer portals and spreadsheets.
One Workspace
Every active auth in a single queue with follow-up dates, adjuster info, and AI next steps. No more juggling tabs, portals, and spreadsheets.
PA Lookup
Check payer requirements for any procedure or CPT code across 28 major payers, before you submit.
Appeal Letters
Denied? Generate formal first, second, or third-level appeal letters in seconds. Export to .docx or .pdf.
Note Checker
Scores a clinical note against payer criteria and rewrites gaps, including conservative-care and continuation-of-care arguments that trip up the most denials.
Insights
See denial patterns, approval trends, and turnaround by payer, so your team knows exactly where authorizations are leaking time and money.
Approval-rate trend, January through June: climbing to 88 percent.
Peer-to-Peer Prep
Surfaces the payer’s peer-to-peer line and generates talking points from the original note and the denial reason, so the call is won before it starts.
A denial engine that gets smarter every month.
Every note check and appeal is grounded in real, cited clinical-trial evidence mapped to each payer's published criteria, not generated from memory. Praxigen also tracks the exact language that gets approved versus denied across every case and payer, then feeds it back in. The more your team uses it, the harder it is for payers to say no.
Built for your whole team.
Every role on a practice's prior-auth workflow gets the view that fits their job.
Office & practice managers
See every auth, deadline, and denial pattern at a glance, and put a number on the time your team gets back.
PA specialists & MAs
Check the note against the payer’s own criteria before you submit. No more guessing what they want.
Billing & RCM teams
Catch auth-vs-claim mismatches before the claim drops, and turn denials into cited, policy-targeted appeals.
Why we’re building this.
Anonymized quotes from our discovery interviews with prior-auth staff, billers, and practice managers.
I have two computer screens with all the stuff open just to get one auth through.
You have patients that suffer for a year waiting for this authorization.
I sit on the phone for hours just trying to see if there’s a prior auth on file.
The cost of waiting
What unmanaged prior auth is quietly costing you
Choose your specialty for a starting estimate, then adjust any number to match your practice.
The AMA finds 81.7% of appealed prior-auth denials are overturned, so most of this is winnable. Praxigen targets it directly: flagging documentation gaps before submission so fewer PAs are denied, and drafting policy-grounded appeals so denials do not get dropped.
Estimate only, for illustration. Not a guarantee of results or approvals. Default assumptions are anchored to published research; specialty presets are typical starting points to adjust to your own data. Denial rates: the U.S. initial claim denial rate was ~11.8% in 2024 (Kodiak Solutions revenue-cycle data, ~2,100 hospitals and 300,000 physicians), an all-claims figure used here as a general starting proxy; for prior authorization specifically, orthopedic ASC cases commonly run 14–22% and interventional pain procedures around 20%. Per-specialty denial presets outside those are typical-range estimates, not exact figures. Most denials are never appealed (the 2024 AMA Prior Authorization Physician Survey found fewer than 1 in 5 physicians, 18%, always appeal), yet of the denials that areappealed, the AMA reports 81.7% are fully or partially overturned. PA volume is anchored to the AMA finding of ~39 prior authorizations per physician per week (practice totals scale with the number of providers). “Revenue at risk” = denied PAs never appealed × average procedure revenue, and excludes delayed approvals, staff time, and patient attrition. Revenue per procedure varies widely by specialty and payer, so enter your own.
You vs the national picture
Where Praxigen moves the needle
Nationally, fewer than 1 in 5 physicians always appeal a denial (AMA). Praxigen drafts the policy-grounded appeal, so far more get filed instead of written off.
Procedural specialties commonly run 14–22% (orthopedic ASC; ~20% interventional pain). The Note Checker flags documentation gaps before submission so fewer are denied.
Winnable revenue = the revenue at risk above × the AMA’s 81.7% overturn rate (the share of dropped denials that would be overturned if pursued). Directional estimate, not a guarantee.
See the full value breakdown for these numbers →And that’s only the cost of standing still. The value of fixing it is the bigger number: winnable revenue recovered, denials headed off before they happen, and your team’s hours back.
Meet the team.
We’re a student-founded team out of the University of Michigan. We kept hearing the same thing from every practice we talked to: prior authorization is broken, and it’s stealing time from patient care. So we’re building the tool we wish they had.
Read why we’re building this
Maya Gerdes
Builds Praxigen end to end: product, engineering, and AI.
Loryn Canty
Leads customer discovery, outreach, and the design-partner pipeline.
Reena Jari
Shapes the brand, story, and content.
Noah Trexler
Runs operations, competitive research, and pilot ops.
Daniel Heiman
Drives market strategy, positioning, and partnerships.