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PayerIQ · executable-demo

PayerIQ Documentation Readiness Demo

Demonstrate how a synthetic authorization scenario becomes a scored documentation-gap packet, reviewer queue, audit trace, and prepare-only workflow handoff.

BuyerPrior authorization, revenue-cycle, utilization-management, access, and finance transformation leaders
AgentDocumentation-Before-Authorization Agent
Proof routes3
Exclusions4
Recommended pilot60-Day Governed Automation Pilot

Synthetic scenario

A registered synthetic authorization packet is checked against symptom, function, timing, rationale, therapy-history, evidence, policy, note, and reviewer requirements without accepting free text or payer identifiers.

Run PayerIQ workbench
01Choose a registered synthetic procedure-authorization scenario.
02Mark the documentation requirements represented in the packet.
03Generate the completeness score, missing-evidence list, reviewer queue, and audit hash.
04Test the payer-action path and confirm it fails closed with no transmission.

Inspectable proof

Workflow, result, governance, and quality evidence remain one click away.

proof route

Interactive workbench

Deterministic completeness scoring, missing-evidence packet, reviewer queue, value assumptions, and payer-action denial.

Inspect Interactive workbench
proof route

Workflow value methodology

Buyer-defined baseline and claims-safe measurement rules for documentation completeness and reviewer effort.

Inspect Workflow value methodology

Commercial path

Recommended next step: 60-Day Governed Automation Pilot

Synthetic Pilot Evaluation

$125k-$350k for a governed synthetic documentation-readiness pilot; buyer-specific policy mapping is separately scoped.

Prior authorization, RCM, utilization-management, access, and finance transformation leaders.

No live PHI, medical-necessity determination, payer submission, appeal filing, EHR writeback, or reimbursement guarantee.
  • The workbench identifies missing documentation and reviewer ownership; it does not determine medical necessity.
  • Pilot value is measured through buyer-approved completeness, reviewer-time, and rework baselines.
  • Payer submission, appeals, reimbursement guarantees, and live PHI remain blocked.
Outcome 01

Documentation completeness score

Documentation gaps surfaced before submission

Outcome 02

Missing-evidence packet

Reviewer queue made explicit

Outcome 03

Reviewer ownership and next actions

Evidence trace retained

Outcome 04

Prepare-only SCRIMED Work handoff

Payer-facing action blocked

Governance boundary

Human-reviewed synthetic evaluation only.

  • Registered synthetic scenarios and enumerated inputs only.
  • Human review remains required for every output.
  • Workflow economics remain assumptions until buyer baselines and finance review exist.
01No live PHI or payer-member identifiers
02No medical-necessity determination
03No prior-authorization or appeal submission
04No reimbursement or denial-reduction guarantee