Agentic AI for healthcare operations

Turn prior auth chaos into clean clinical action.

FHIRant reads payer policies, faxes, PDFs, oncology notes, pharmacy packets, and FHIR resources, then builds traceable authorization workflows your team can audit, submit, and scale.

Request a pilot See the Policy Graph
FHIRNative workflow outputs
CRD/DTRCoverage and documentation ready
PASEvidence packages for review
The Problem

Healthcare teams are still stitching decisions together by hand.

Prior authorization work lives across payer PDFs, medical policies, chart notes, portals, specialty pharmacy queues, and scanned packets. FHIRant turns that fragmented evidence into structured, explainable work.

Intake

Documents become data.

Parse faxes, PDFs, chart attachments, policy documents, and forms into clean clinical and administrative entities.

Reasoning

Policies become pathways.

Normalize criteria, exclusions, step therapy, medical necessity language, and documentation rules into a queryable graph.

Output

Review becomes auditable.

Generate missing-evidence prompts, source-linked recommendations, and FHIR/JSON artifacts for downstream systems.

Policy Graph

Every recommendation has a trail.

FHIRant connects payer rules to patient evidence, then shows what is satisfied, missing, contradictory, or ready for submission.

01

Ingest policy and case materials

Accept payer policies, forms, faxes, denial letters, clinical packets, FHIR Bundles, and case metadata.

02

Extract the clinical facts that matter

Identify diagnoses, CPT/HCPCS, medications, labs, biomarkers, staging, prior therapy, dates, and document sources.

03

Compare evidence against payer criteria

Map the case to medical necessity language, plan requirements, exclusions, continuation rules, and missing documentation.

04

Produce explainable workflow outputs

Send structured FHIR/JSON, reviewer prompts, submission packets, source citations, and next actions into the workflow.

FHIRant Sidekicks

Focused automation for high-friction authorization work.

Start with one workflow where complexity is expensive, then expand the same Policy Graph foundation across intake, review, appeal, and reimbursement operations.

PAS Sidekick Oncology

Oncology

For oncology authorization workflows where treatment history, pathology, biomarkers, staging, and regimen rules all shape the decision.

  • Review notes, labs, pathology reports, and treatment plans.
  • Catch missing biomarkers, prior therapies, and dosing context.
  • Trace patient evidence back to payer policy criteria.

Specialty Pharmacy Sidekick

Rx

For specialty medication intake, benefits verification, prior authorization support, and reimbursement coordination.

  • Organize prescriptions, benefits data, and clinical evidence.
  • Surface coverage barriers and next-best actions.
  • Create structured artifacts for pharmacy, hub, and access teams.

Policy Graph API

Platform

For teams that need policy intelligence, documentation checks, and prior authorization status embedded in existing systems.

  • Submit PDF, FHIR, JSON, and webhook-based workflow events.
  • Query by payer, plan, service, diagnosis, drug, or code.
  • Return criteria matches, validation status, and decision traces.
Workflow

From messy packet to ready-to-review case.

FHIRant is built for the practical middle of healthcare operations: where forms, policies, portals, clinical evidence, and reimbursement logic collide.

Capture the work as it arrives

Bring together faxes, PDFs, payer policies, chart notes, FHIR resources, and case metadata without forcing teams into a new front door.

Generate a case-specific checklist

Translate payer rules into the exact documentation needed for the request, with missing items highlighted before submission.

Route with confidence

Send the case to intake staff, pharmacists, nurses, or clinical reviewers with the evidence, policy sources, and next action already attached.

Integrate the output

Package the decision trail into FHIR/JSON for PAS, UM, pharmacy, case management, CRM, or internal automation workflows.

Interoperability

Designed for standards-aware operations.

CRD-ready checks

Use policy criteria and patient context to surface coverage and documentation signals before the request moves downstream.

DTR-style guidance

Convert payer criteria into missing-evidence prompts, documentation tasks, and questionnaire-ready guidance.

PAS-ready packages

Bundle source policy, clinical evidence, graph matches, and workflow context into structured outputs for review and submission.

Inputs

Built to accept the messy reality of healthcare data.

PDFClinical packets, faxes, payer forms, policies, and denial letters.
FHIRBundles, Coverage, ServiceRequest, MedicationRequest, Claim, Task, and DocumentReference.
JSONPayer, plan, drug, code, patient evidence, and workflow event payloads.
WEBCallbacks for extraction, policy match, missing evidence, and status changes.

Launch a focused automation pilot.

Pick a workflow, bring real policies and cases, and see how FHIRant turns fragmented authorization work into structured, traceable action.

Contact FHIRant Back to top