Seamlessly integrate enterprise-grade AI into your existing systems. Our API automates healthcare claims processing, cutting costs and speeding up approvals without disrupting your workflow.
Multiple AI agents trained to handle different tasks. Each model is extensivly trained on its own dataset to perform its specific functions. All of the agents are designed to work with your data as well as custom data to provide you with the best possible results.
Seamlessly integrate our AI solutions with your current healthcare systems for a smooth transition and enhanced workflow.
Tailored AI solutions designed specifically for your organization's unique prior authorization requirements.
Powerful and flexible APIs that enable seamless integration and automation of your prior authorization processes.
CHAI integrates directly into your infrastructure through a simple API. You send us the case data — from PDFs, EHR exports, or claims systems — and our specialized AI agents handle intake, coverage checks, clinical validation, and decision support. We return structured decisions in real time, fully tailored to your payor rules.
Send us any prior authorization data — PDFs, faxes, EHR exports, or structured JSON — and CHAI’s Intake Agent will parse, normalize, and structure it into a machine-readable format. Our system adapts to your data format and delivery method, ensuring a seamless ingestion pipeline that requires no major infrastructure changes.
Our specialized agents verify coverage against payor policies, PBMs, and patient plan coverage. They conduct clinical assessments based on medical necessity guidelines trained on terabytes of clinical data and payor rules. This step checks for tiered coverage, quantity limits, exclusions, step therapy, and clinical appropriateness.
Every decision is fully auditable. Our system compiles all applied rules, data sources, and rationale, ensuring compliance and traceability. Structured decisions — approvals, denials, or escalation flags — are returned in real time through the API.
Upload a policy in PDF or plain text — our AI parses and converts it into a structured, editable decision tree in seconds. Whether it's step therapy, tier restrictions, or prescriber rules, our system breaks it all down into clear, customizable logic blocks you can edit anytime.
Upload your prior authorization policies in PDF or text format. CHAI's AI engine will instantly convert them into structured, editable decision trees — built for speed, accuracy, and compliance. No more manual logic mapping.
Every branch in the tree is fully customizable — update conditions, reword questions, or insert new criteria anytime. Maintain control without starting from scratch.
Our AI agents use these trees to make real-time decisions. Whether it's verifying coverage rules or generating approval/denial letters, you get end-to-end automation that's explainable and auditable.
Our AI agents reduce friction across every step of the authorization process—cutting processing times, improving approvals, and reducing manual work. Here's what our partners have seen:
95%
30%
1.5min
AI for Prior Authorizations
"In this episode, we explore how AI is revolutionizing prior authorization and claims processing in healthcare payer organizations. From eliminating manual bottlenecks to complying with CMS-0057-F, learn how intelligent automation is driving faster approvals, lower costs, and better patient outcomes."
Deep dive into CMS-0057-F Changes
"In this episode, we break down the new CMS-0057-F Final Rule and what it means for Medicare Advantage plans. From faster prior authorization decisions to mandatory FHIR-based APIs, we cover the biggest changes, the 2026–2027 compliance deadlines, and the operational and technical steps plans need to take. Whether you're on the product, compliance, or engineering team, this is your guide to understanding what's coming—and how to stay ahead of it."
Built for enterprises—handle millions of requests with zero downtime.
