Prior Authorization Software to Reduce Denials
The end-to-end Prior Authorization Software that automates authorization checks, reduces avoidable denials, and accelerates approval workflows across your revenue cycle.
Trusted by the best in the industry
AI-Powered Prior Authorization to Cut Denials and Speed Up Approvals
Maximize Compliance
- Stay aligned with payer prior authorization rules using daily-refreshed Smart Edits.
- Detect eligibility and prior authorization needs with real-time API lookups.
- Reduce compliance risk through continuous payer-policy monitoring.
Improve Claims Accuracy
- Prevent PA-related denials with AI checks for missing docs and coverage gaps.
- Catch outdated or incorrect authorization details before billing.
- Ensure accurate ICD-10, CPT, HCPCS, and HCC coding with audited guideline compliance.
Optimize Prior Authorization Workflows
- Automatically identify PA requirements via real-time eligibility and coverage checks.
- Analyze with Rapid Agents (LLM + ML) that continuously learn from payer responses.
- Maintain complete audit trails with transparent edits and system logs.
AI-Powered Revenue Cycle Optimization Suite
Automated PA Eligibility & Coverage Checks
Accelerate authorization workflows with real-time payer verification. RapidClaims connects directly to payer and clearinghouse APIs to detect authorization needs before a claim is created.
- Live eligibility & PA hooks that surface required authorizations instantly
- AI-powered validation of documentation for faster approval
- Real-time payer-policy updates to prevent misinformation and delays
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AI-Driven Coding & Documentation Integrity
RapidClaims’ RapidCode and RapidCDI modules accelerate clean-claim generation, ensuring coding accuracy, RAF compliance, and faster reimbursement across specialties.
- 96%+ accurate autonomous coding at 1,000+ charts/min
- Inline HCC and RAF detection before note sign-off
- Transparent audit trails and line-level AI rationale
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Intelligent Denial Prevention & Automated Appeals Engine
RapidScrub and RapidRecovery work together to prevent denials before they occur and automatically recover missed revenue. The platform blends predictive scoring with automated appeals and continuous feedback loops.
- AI Smart-Edit Engine detects coverage gaps and coding errors pre-claim
- Flags high-risk claims and underpayments in real time
- Automated appeal generation and electronic submission
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What Sets Us Apart
Proven Results
- Achieve a 98 % clean-claim rate with end-to-end coding, CDI, and denial-prevention automation.
- Improve coder productivity by 170 % using RapidCode for autonomous, audit-ready claim generation.
- Increase HCC capture by 24 % through RapidCDI’s point-of-care risk-adjustment optimization.
Security That Matters
- End-to-end encryption for patient and clinical data
- HIPAA, SOC 2, and ISO 27001-aligned infrastructure
- Role-based access to protect sensitive authorization information
Real Partnership
- Dedicated implementation and workflow alignment in under 30 days
- Ongoing training to help teams adapt to evolving payer rules
- Ongoing platform improvements driven by real-world provider feedback
Results You Can Trust
RapidClaims delivered what other vendors only promised. We've seen a 30% reduction in AR days within one quarter, unlocking $2.5M in accelerated cash flow. Their platform adapts to our specific workflows instead of forcing us to change our processes.
CFO, Major Health System
$2.5M
Accelerated cash flow
30%
Reduction in AR days
"With RapidClaims, we're maximizing our limited resources while improving revenue capture by 5%. Our team now spends more time on patient care and less on administrative tasks."
Director HIM, Federally Qualified Health Center
5%
↑ increased revenue
40%
Reduction in coding and billing costs
RapidRisk transformed our value-based care documentation, improving RAF by 15% and reducing documentation gaps by 22%. This directly impacts our shared savings and quality metrics.
Medical Director, Leading Accountable Care Organization
15%
↑ RAF
45%
New conditions identified
Our clean claim rate jumped from 92% to 99% with a 96% first pass yield rate. With RapidClaims, we improved the productivity of our coding staff by 100%. Our team only focuses on complex cases that require human expertise.
VP Revenue Cycle, Multi-Specialty Physician Group
27%
Reduction in claim denials
70%
Reduction in cost to collect
Faster Authorizations, Fewer Delays
Accelerate approvals with real-time eligibility lookups, Smart Edits for PA rules, and automated document validation powered by Rapid Agents.
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Frequently Asked Questions
Transform Your Revenue Cycle in 30 Days or Less
Join leading healthcare organizations already seeing results with RapidClaims.
