TruthNexus
Prior Authorization · Medical

Prior auth that's defensible — not just fast

$13B per year in administrative burden. 82% of physicians say prior auth delays necessary care. Skippy Auth returns evidence-grounded recommendations with full citation to clinical guidelines and NCD/LCD policies — defensible to CMS, ready for appeals.

250M
Prior authorization requests processed by CMS annually
75%
Of initial PA denials are overturned on appeal
14 hrs
Physician time per week spent on prior auth (AMA)
92%
Of cases involve care delays or treatment abandonment
CMS-0057-F · January 2027 mandate

Where AI is used to support prior authorization decisions, the rationale must be traceable to specific clinical criteria that are publicly available and versioned. A black-box model or ungrounded LLM cannot satisfy this requirement. Skippy Auth returns a specific source document ID, version date, and evidence citation — with every decision.

Capabilities

What Auth does

Evidence-grounded recommendations

Every Approve / Deny / Request More Info recommendation is backed by cited clinical evidence — guidelines, systematic reviews, NCD/LCD policies — not heuristics or black-box rules. The rationale travels with the decision.

FHIR ClaimResponse with traceable criteria

Returns HL7 FHIR R4 ClaimResponse with every denial citing the specific named criterion, version date, and evidence source — satisfying CMS-0057-F's requirement that AI-assisted PA rationale be traceable to publicly available, versioned clinical criteria.

Step therapy enforcement

Evaluates step therapy requirements from payer policies against the patient's medication history — flagging when step therapy documentation is incomplete and generating the specific documentation request the provider needs to satisfy it.

Appeal reconstruction

Every decision generates a complete reconstruction package: the original decision record, the evidence evaluated, confidence at decision time, and the full rationale chain. Reconstructed from the SHA-256 hash-chained audit log — tamper-evident, available years after the original decision.

CMS reason codes

Returns structured CMS reason codes (A1 for approval; D1–D5 for denial reasons; P1–P3 for pending) alongside the evidence chain — enabling downstream systems to route decisions without parsing free-text rationale.

HL7 FHIR PAS native

Native support for HL7 FHIR Prior Authorization Support (PAS) profile. Plugs into existing EHR and payer infrastructure without a custom integration layer.

Who It's For

Payers, plans, and integrated systems

Health Plans
Reduce denial-to-appeal cycle time and administrative overhead at scale.
PBMs
Evidence-grounded formulary exception decisions with complete audit trail.
Integrated Health Systems
Streamline internal PA workflows with defensible, auditable recommendations.
Benefits Administrators
Audit-ready decisions that reduce liability and improve member outcomes.
Regulatory

CMS-defensible by construction

Every authorization decision is traceable to the clinical evidence that supports it. NCD/LCD citations, guideline references, and formulary rules are preserved in the decision record — making every recommendation independently verifiable.

Each decision generates a SHA-256 hash-chained audit record stored in an append-only log — tamper-evident, retained for 7 years, and reconstructable for appeal hearings. HIPAA-ready with full BAA available.

CMS-0057-F effective January 2027 requires AI-assisted PA denials to cite specific, publicly available, versioned clinical criteria. Skippy Auth satisfies this by construction — the citation is structural, not optional.

HIPAA ReadyCMS-0057-FNCQA AlignedHL7 FHIR PASSHA-256 Audit Chain7-Year Retention

See Auth in your PA workflow

We work with health plans, PBMs, and integrated health systems. Let's talk about your prior authorization problem.