Priorly provides an automated prior‑authorization platform that integrates with EMR/EHR systems via HL7/FHIR APIs, extracting patient and medication data to auto‑populate insurer portals with a single click. The solution monitors request status in real time, sending updates to provider dashboards and patient SMS, cutting submission time to under five minutes while maintaining HIPAA‑compliant security.
Funding
Funding not disclosed
Founders
Product
Problem
Healthcare providers spend significant time manually completing prior‑authorization forms, contacting insurers, and following up with patients, which leads to workflow inefficiencies, delayed treatment initiation, and fragmented communication.
Solution
Priorly delivers an automated prior‑authorization engine that integrates directly with EMR/EHR systems via secure APIs. When a prescription triggers an authorization request, the platform extracts the relevant patient and medication data with a single click and populates the insurer’s web portal automatically. A background status‑monitoring service polls the insurer’s portal in real time and pushes updates to both the provider dashboard and the patient’s mobile phone via SMS. The solution reduces average submission time from dozens of minutes to under five minutes and eliminates manual follow‑up calls. All data exchanges are encrypted and logged for audit compliance, and the system scales across multiple payer networks without additional configuration.
Target Audience
The primary customers are outpatient clinics, specialty physician groups, and health systems that manage high volumes of prior‑authorization requests for prescription therapies.
Features
- Bidirectional EMR/EHR integration using HL7/FHIR APIs for automatic patient‑history retrieval
- One‑click form generation that maps clinical data to insurer‑specific fields and submits via robotic process automation (RPA)
- Real‑time status polling engine with webhook notifications to provider portals and patient SMS alerts
- HIPAA‑compliant data encryption at rest and in transit, with role‑based access controls and full audit trails
- 99.9 % uptime SLA backed by cloud‑native microservices architecture and auto‑scaling containers
- Multi‑payer support with configurable rule sets for different authorization criteria and documentation requirements
- Analytics dashboard showing average turnaround time, approval rates, and bottleneck insights for continuous process improvement
- Customizable workflow hooks that allow clinics to trigger downstream actions (e.g., pharmacy order creation) upon approval