Current prior authorization workflows are slow, manual, and error-prone–leading to frequent denials that drive up costs and delay critical care. By January 2027, CMS requires many health plans to implement a Prior Authorization API that supports electronic submission of requests, documentation, and decisions—enabling fully digital prior authorization workflows.
Redox helps you stay modern and compliant, while realizing significant cost savings. With fully electronic processing, CAQH estimates you will save $3.47 on every transaction, which can add up to millions in annual savings for most payers. This is a true win-win for everyone, especially your members who will get the care they need, faster.