Streamline prior authorization
Take the quickest path to compliance, happier members, and massive savings
By January 2027, CMS requires most health plans to implement a Prior Authorization Requirements, Documentation, and Decision (PARDD) API to enable fully electronic prior authorization processing.
Redox helps you ensure compliance while also 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.
Case study
A tangled web of clinical and administrative data spread across disparate systems makes informed prior authorization decisions daunting. This case study explores how Redox is untangling the web — connecting payers, providers, and vendor solutions.
How it works
Redox enables true end-to-end electronic prior authorization between payers and providers. By embedding prior authorization solutions directly into provider electronic health record workflows, Redox eliminates cumbersome fax and web portals. Redox translates X12 messages to HL7® FHIR® (and back again) following Da Vinci implementation guides to ensure forward and backward compatibility and compliance.
See our prior authorization use case in action
HL7® is a registered trademark of Health Level Seven International. The use of this trademark does not constitute an endorsement by HL7.
FHIR® is a registered trademark of Health Level Seven (HL7) and is used with the permission of HL7. Use of this trademark does not constitute an endorsement of products/services by HL7®.