Prior authorization that a clinician actually stands behind.
AIPrism reads your clinical documentation against payer policy and drafts prior-authorization requests and denial-risk assessments for orthopedic procedures. Every draft is unreviewed until a licensed clinician approves, edits, or rejects it — with a full immutable audit trail.
Not a black-box auto-approver. A clinician-supervised drafting assistant with full provenance.
- 2026-07-24 09:14 · AIPrism · drafted PA-2847 + risk assessment
- 2026-07-24 10:02 · Dr. R. Álvarez · opened case for review
Four stages. One beam of light. One licensed decision-maker.
- 01
Documentation in
AIPrism ingests the clinical note, imaging report, and any prior conservative-care history for the case.
- 02
AI drafts request + risk flag
The model reads the documentation against the specific payer policy and drafts the PA with a denial-risk assessment.
- 03
Clinician reviews, edits, approves or rejects
A licensed clinician is always the decision-maker. Nothing leaves AIPrism until they say so.
- 04
Immutable audit trail
Every draft, edit, approval, and rejection is recorded with actor, timestamp, and content — tamper-evident by design.
A drafting assistant, a review workflow, and a paper trail.
Immutable audit trail
Every state change is captured with actor and timestamp. Entries cannot be edited or deleted through the UI.
- 2026-07-24 09:14:02ZAIPrism · Drafted PA-2847 + risk assessment (High)
- 2026-07-24 10:02:41ZDr. R. Álvarez · Opened case for review
- 2026-07-24 10:11:07ZDr. R. Álvarez · Edited: added psych-eval attestation reference
- 2026-07-24 10:11:52ZDr. R. Álvarez · Approved edited draft
AI risk-flagged drafting
AIPrism drafts each PA request and flags the specific policy criteria most likely to trigger denial, with citations.
Clinician review queue
A single prioritized queue sorts pending cases by risk and wait time, so the highest-stakes work surfaces first.
Analytics
Clinician turnaround, edit rate, rejection rate, and risk concentration by payer — live from case state.
FHIR interoperability
Roadmap for SMART on FHIR launch and Coverage/Claim/Condition mapping into the Case model.
Built with security and auditability as a first-class feature.
AIPrism is early-stage. Our SOC 2 and HIPAA compliance program is underway — no audit has been completed yet, and we will not describe AIPrism as SOC 2 certified, SOC 2 compliant, or HIPAA compliant until it is. This section is a roadmap, not a badge wall.
What is real today: an immutable audit trail on every case, and a product designed around a licensed clinician as the decision-maker.
- Live today
Immutable audit logging
Every draft, edit, approval, and rejection is captured with actor and timestamp, and cannot be modified through the product surface.
- In progress
Encryption in transit and at rest
TLS 1.2+ in transit and provider-managed encryption at rest, with a full key-management review underway.
- In progress
SSO-ready RBAC
Role-based access controls with SAML/OIDC single sign-on for practice and health-system deployments.
- Required before real PHI
Signed BAA / DPA
A signed Business Associate Agreement (and DPA where applicable) is a hard gate before any real patient data is processed.
- Planned
SOC 2 Type I → Type II
Controls are being built to be audit-ready. No certificate has been issued yet — and we will not claim one until it has.
Bring AIPrism to your orthopedic practice.
We work with a small number of design partners at a time. Tell us about your practice and the procedures where prior auth is the biggest drag today, and we'll be in touch.
- No real PHI in the demo — all data is synthetic
- Signed BAA before we touch any real patient record
- Clinician review is required, not optional