Authorization intelligence workspace

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Monitor approval confidence, missing criteria, payer friction, and readiness across active cases.

82/100

Overall Clariq Confidence™

Approval Likelihood

Moderate

Confidence increased from 68 → 82 after readiness updates.

View insights →

Cases Analyzed

128

↑ 18% vs last 30 days

Ready to Submit

41%

↑ 12% vs last 30 days

Avg. Confidence

79%

↑ 8% vs last 30 days

Potential Impact

$2.4M

↑ 22% vs last 30 days

Clariq Insight

BCBS IL approvals drop 22% when IgG labs are missing.

High-impact documentation gaps are surfaced before submission so teams can strengthen the request earlier.

Active Case

IVIG / BCBS IL PPO

Needs Review
2 missing items reducing approval likelihood
View full criteria →
82/100

Moderate Chance of Approval

Strengthen missing criteria and documents to increase confidence.

Confidence Scoring Logic

Clinical30%
Documentation25%
Payer Policy25%
History20%

Where Clariq Fits

View workflow →
IntakeDocsClariqSubmitOutcome

Clariq sits before payer submission to validate readiness and guide stronger authorization decisions.

Live Simulation

Connected
128Cases analyzed
41%Ready to submit
Updated 2 min agoBackend signal

Payer Updates

View all
BCBS ILUpdated PA criteria — May 2024
AetnaNew step therapy policy
United HealthcarePrior auth changes
CignaUpdated formulary

Workflow Summary

  • Ready to Submit 41%
  • In Progress 35%
  • Needs Attention 24%

Activity Feed

View all
Lab results uploaded2 min ago
Document attached8 min ago
Case reviewed15 min ago

Case management

Operational Case Queue

Prioritize authorization work by risk, readiness, payer, and next-best action.

High Risk

1

Needs immediate action

Needs Review

2

Missing requirements

Ready

1

Submission-ready

Avg. Confidence

78%

Across active queue

Analytics layer

Approval Intelligence Trends

Clariq turns repeated authorization friction into decision intelligence across payers, therapies, documentation gaps, and outcomes.

Detected Intelligence

BCBS IL shows 22% lower approval when IgG labs are missing.

Clariq surfaces high-impact documentation patterns before teams submit, shifting prior authorization from reactive follow-up to proactive readiness.

22% approval drop 38% top denial driver 2.4 days faster readiness

Preventable Denials

31%

linked to missing docs

Best Performing Payer

Medicare

91% confidence avg.

Most Common Gap

Labs

IgG / clinical thresholds

Time Saved

2.4d

avg. readiness improvement

Top Denial Drivers

View drivers
Missing lab thresholds38%
Prior therapy evidence28%
Clinical notes incomplete21%
Site of care mismatch13%

Missing Documentation Trends

Monthly

AI Insight Feed

Live
High ImpactUpload IgG labs before BCBS submission.
Pattern FoundAetna cases improve after prior therapy history is attached.
Operational TipMedicare packets are ready faster when billing criteria are verified upfront.

Time-to-Approval Improvement

2.4 daysAverage review time improvement after readiness checks
31%Reduction in preventable rework loops
$2.4MPotential recovered revenue per 1,000 cases

Payer Intelligence Snapshot

PayerAvg. ConfidenceTop Gap
BCBS IL82%IgG Labs
Aetna65%Prior Therapy
Medicare91%Billing Rules
Cigna75%Site of Care

Workflow positioning

Clariq Intercepts Before Submission

Clariq adds a pre-submission intelligence layer across intake, documentation, payer logic, submission, and outcome tracking.

Authorization Flow

Before the payer sees the request

Pre-submission layer
1IntakePatient + therapy request enters workflow
2DocumentationClinical notes, labs, prior therapy history
Clariq LayerConfidence score, gaps, payer rules, next actions
4SubmissionCleaner packet sent to payer
5OutcomeApproval, denial, or escalation tracked
Clariq intercepts before submission. That is the operational advantage: teams improve the request before the payer ever sees it.

Workflow Impact

30–40%Potential approval lift
25–35%Potential denial reduction
2.4dAverage readiness improvement

Data Sources

Payer Policies & GuidelinesCoverage rules and prior authorization criteria
Clinical GuidelinesEvidence-based protocols, labs, and pathways
Claims & Real-World DataHistorical outcomes and authorization trends
Provider & Patient DataClinical records and treatment history

System Positioning

EHRPharmacyBenefitsPayer Rules Clariq Intelligence PA SubmissionAppealsRevenue CycleOutcomes

What Clariq Does at Each Step

1Reads payer and plan-specific requirements
2Compares documentation against approval criteria
3Scores readiness and highlights risk drivers
4Recommends next-best actions before submission

Investor view

Why Clariq, Why Now

Prior authorization is a system-wide workflow problem across healthcare.

ROI story

$2.4M potential recovered revenue per 1,000 cases

By reducing preventable denials, missing-document rework, and payer back-and-forth, Clariq becomes an operational and financial decision layer.

30–40%Approval lift25–35%Denial reduction2–4xROI potential

Problem

Teams submit without enough visibility into approval likelihood, payer-specific criteria, and missing evidence.

Solution

Clariq predicts approval likelihood, identifies missing criteria, and recommends next-best actions.

Market Fit

Hospitals, infusion centers, outpatient clinics, specialty pharmacies, patient access, and revenue cycle.

Data Moat

Payer rules, clinical criteria, authorization outcomes, and operational patterns improve over time.

Investor Demo

Investor demo walkthrough

Auto-play a short investor walkthrough showing how Clariq improves readiness before submission.