Clinical Intelligence Platform

Prior auth and appeals, finally automated.

Not routed to a queue. Executed.

Almvia reads the denial, pulls evidence from your EHR, matches it to the payer's policy, and drafts a cited appeal. All before anyone opens their inbox.

Join the Pilot Program See how it works
01
Denial detected
CMS denial code parsed
02
Chart retrieved
FHIR R4 + unstructured sources
03
Policy matched
Evidence cited to source & date
04
Appeal drafted
Review, approve, submit
✓
Appeal ready
Fully cited, audit-logged
0
Staff hours per physician
per week on prior auth
AMA, 2024
0%
Claim denial rate in 2024,
up 2.4 points YoY
HFMA, 2024
0%
Prior auths still
processed fully by hand
CAQH, 2024

The problem

13 hours a week per physician.
Gone.

Your staff hunts through charts, faxes, and payer policies for every single prior auth. When the insurer denies, they do it all over again. Most appeals are generic or never filed at all. That revenue just disappears.

Almvia changes that. Completely.

What's coming

One system. Every step.

Prior authorization

Detects new cases, builds the packet, and flags gaps before submission.

Denial response

Catches denials instantly, pulls the exact evidence, drafts the appeal point by point.

Resolution tracking

Every outcome logged. Every submission improved by the last.

Prior authorization

Stop denials before they happen.

Most denials are preventable. Almvia watches your EHR in real time, catches cases that need prior auth, and builds the packet automatically. It flags gaps before anything goes out the door.

Every prior auth request gets

  • Clinical summary linking diagnosis to payer criteria.
  • Cited evidence list with notes, labs, and imaging, each tied to source and date.
  • Missing items flagged before the payer has to ask.
  • Portal-ready bundle, formatted and ready to submit.

Get it right the first time. Every avoided denial is hours your team gets back.

Denials and appeals

Denial arrives. Appeal's already written.

Fax, PDF, remit file. Doesn't matter how it arrives. Almvia catches it, reads the specific denial reason, and pinpoints exactly what the payer says was missing.

Then it pulls the chart evidence that directly addresses that criterion. Not a generic summary. The specific documentation, cited to source, date, and page.

The appeal gets drafted point by point in the payer's required format. Your staff reviews, edits, and approves. Nothing leaves without sign-off. Every action logged and every outcome tracked, so the next submission is smarter.

Why now

New federal rules require payers to give specific denial reasons and accept prior auth via FHIR API. The infrastructure finally exists. Almvia is built to use it.

CMS-0057-F · 21st Century Cures Act · FHIR R4 Native

CAQH estimates full electronic prior auth adoption saves the industry $515M a year. That window opens in 2027. We're building for it now.

Early access

Be one of the first ten.

We're hand-picking 10 practices for a 90-day pilot. No cost, no contract. Just real cases and real results.

  • FHIR-connected to your EHR in two weeks.
  • Live prior auth and appeal drafts from your real workflow.
  • Full ROI report at 90 days covering time saved, denial recovery, and revenue impact.
  • Direct access to our founding team the entire time.

Starting with ortho, oncology, cardiology, and neurology.

Limited to 10 practices. We'll reach out within 48 hours.