How it works
What is Praxigen?
Praxigen is an AI-native prior authorization platform for specialty practices. It turns the slow, fragmented work of matching clinical notes to payer rules into one workflow, with justifications grounded in cited sources that your team can review and stand behind.
What is Praxigen?
Praxigen is an AI-native prior authorization platform for specialty medical practices. Prior authorization is one of the most manual, fragmented workflows in healthcare: every payer has different rules, and the clinical justification has to match them exactly. Praxigen brings payer-requirement lookup, a case workspace, clinical-note checking, and appeal-letter generation into one workflow, so your team spends less time on paperwork and more time on patients.
How Praxigen handles patient data during the pilot
Praxigen is not yet HIPAA-compliant, so the pilot runs on de-identified or sample data only. Patient identifiers are removed on your own device before anything is sent to Praxigen, and your team reviews the de-identified output. Full HIPAA controls, including signed Business Associate Agreements and audit logging, are on our roadmap as we onboard more practices and scale.
A source-grounded database, not a guessing AI
The reason Praxigen’s output is trustworthy is that the AI is a tool, not the source of truth. Praxigen maintains a database that cross-references clinical trials, CMS coverage policy, payer medical-necessity criteria, and legislation. Each justification shows the citation behind it, so your staff can review the source and stand behind what they submit. Conservative defaults and a human-in-the-loop review keep the clinical meaning intact.
How Praxigen keeps payer rules current
Payers change medical-necessity guidelines often, and a justification that is correct today can be denied next month if the rules moved. Praxigen’s intelligence layer updates continuously: the CPT and HCPCS code registry checks CMS releases monthly, payer-requirement changes are tracked with a full version history, and federal rule-making is monitored weekly. When a policy changes, the cited criteria change with it.
You stay in control: human-in-the-loop, never auto-submitted
Praxigen prepares the prior authorization and you review, copy, and submit it yourself. Nothing is submitted automatically under your provider numbers. This keeps your billing team in full control during the earliest, most hands-on stage of the product.
FAQ
Frequently asked questions
What is Praxigen?
Praxigen is an AI-native prior authorization platform for specialty medical practices. It helps your team look up payer requirements, assemble source-grounded medical-necessity justifications, check clinical notes, and generate appeal letters, all in one workflow. The AI is the tool; a database of cited clinical and policy sources is the source of truth.
Is Praxigen HIPAA compliant?
Not yet. During the pilot you work with de-identified or sample data: patient identifiers are removed on your own device before anything is sent to Praxigen. Full HIPAA controls, including signed BAAs and audit logging, are on our roadmap as we scale.
How does Praxigen avoid AI hallucinations?
Every justification is grounded in a cited source. Praxigen cross-references clinical trials, CMS coverage policy, payer medical-necessity criteria, and legislation, and shows the citation behind each claim. You review and edit before anything is submitted, and Praxigen never submits on your behalf.
How does Praxigen keep payer rules current?
Praxigen’s intelligence layer updates continuously: the CPT and HCPCS code registry checks CMS releases monthly, payer-requirement changes are tracked with a full history, and federal rule-making is monitored weekly. When a payer or policy changes, the cited criteria change with it.
Does Praxigen submit prior authorizations automatically?
No. Praxigen prepares the request and you review, copy, and submit it yourself. A human is always in the loop, so your team keeps full control over what is sent under your provider numbers.
How much does the Praxigen pilot cost?
The pilot is a 6-month design-partner agreement. The first 2 months are free with full access. At month 2 you get a KPI report on your results and choose whether to continue. If you opt in, it is a flat $299 per month for months 2 through 6, one rate for the whole practice.
Who is Praxigen for?
Small and mid-size specialty practices with meaningful prior-authorization volume, where denials and turnaround time are a real administrative burden.