Eliminate Prior Auth Bottlenecks From 7 Days to 15 Minutes
Automatically interrogate commercial and Medicare Advantage rules, extract clinical justification from EHR notes, and submit clean electronic 278 authorization requests.
How Nousvia Prior Authorization Operates
Zero portal hopping. Zero phone hold queues. Zero patient care delays.
Order Intercept & Determination
Detects pending order in EHR and verifies whether prior authorization is mandated for the patient's specific plan.
Clinical Policy Mapping
Maps order to specific clinical guidelines (e.g. prior physical therapy duration, BMI threshold, step therapy history).
Evidence Gathering & Packet Assembly
Extracts documented clinical notes, diagnostic imaging reports, and lab panels supporting each requirement.
Electronic Transmission & Status Tracking
Dispatches packet to payer portal or clearinghouse and monitors real-time status until approval number is issued.
Comprehensive Prior Authorization Engine
Engineered for surgeries, specialty medications, and advanced imaging.
Real-Time Order Interception
Captures advanced imaging, surgery, and specialty medication orders the moment physicians sign them.
Dynamic Payer Rule Engine
Continuously updated rule library for 1,200+ commercial, Medicare Advantage, and Medicaid health plans.
Automated Clinical Evidence Extraction
Pulls clinical history, conservative therapy trials, imaging reports, and lab results without manual chart hunting.
Direct Payer API Submissions
Submits via modern 278 transactions and direct payer APIs, bypassing antiquated fax and manual portal uploads.
Prior Authorization FAQs
Learn how we support over 1,200 commercial health plans.
Nousvia supports all major national payers (UnitedHealthcare, Anthem/Elevance, Aetna, Cigna, Humana) as well as regional Blue Cross Blue Shield plans and Medicare Advantage. Supported service categories include MRI/CT, oncology infusions, orthopedic surgery, and cardiac procedures.