Fairway Health provides an AI‑powered platform that automates prior‑authorization workflows by extracting clinical data from EHRs, matching it to payer criteria, and delivering real‑time approval recommendations. Integrated via HL7/FHIR APIs, the solution reduces manual effort, speeds treatment initiation, and offers analytics on turnaround times and denial rates for hospitals, health systems, physician groups, and health plans.
Funding
$500K raised to dateRaised to date based on public sources. This may differ from the amount the company actually raised and is based only on what is publicly available on the internet.
Founders
Product
Problem
Prior authorization processes are often manual, time‑intensive, and prone to errors, creating delays in patient care and administrative burden for providers and payers.
Solution
Fairway Health offers an artificial‑intelligence platform that automates the prior authorization workflow by extracting clinical data, matching it against payer criteria, and generating evidence‑based approval recommendations. The system integrates directly with electronic health record (EHR) and practice management systems to submit requests in real time, reducing the need for phone calls and faxed paperwork. Continuous learning algorithms improve decision accuracy as more cases are processed, while built‑in compliance checks ensure adherence to payer policies. Providers receive instant feedback within their clinical workflow, enabling faster treatment initiation and lower administrative costs.
Target Audience
Primary customers are hospitals, health systems, and physician groups that manage high volumes of prior‑authorization requests, as well as health plans seeking to streamline their review processes.
Features
- AI‑driven clinical data extraction and eligibility verification from EHRs
- Automated rule‑based matching to payer prior‑auth criteria with real‑time decision support
- Seamless integration via HL7/FHIR APIs for bidirectional data exchange
- Adaptive learning models that refine approval predictions based on outcomes
- Compliance engine that enforces payer policies and captures audit trails
- Dashboard analytics for tracking turnaround times, denial rates, and cost savings