Complex criteria
Requirements can vary by therapy, diagnosis, benefit type, plan, and policy version—creating uncertainty before a request is submitted.
Prior authorization readiness intelligence
Know what is missing before you submit.
Clariq Health transforms applicable coverage requirements into a clear, review-ready action plan—so specialty pharmacy and provider teams can resolve documentation gaps before they become avoidable delays.
Designed as a transparent readiness workflow—not a payer coverage determination or guarantee of approval.
Readiness overviewDemo data
Submission Readiness
68/ 100
Needs evidence
Top gaps to resolve
1Document prior therapy response
2Add treatment start and end dates
3Attach baseline severity evidence
Recent fictional cases
Demo Specialty Therapy · Sample PlanNeeds evidence
Demo Infusion · Sample PPOReady for review
Demo Biologic · Sample HMOHard stop
The operational problem
The problem is not always the PA form.
Coverage rules may exist, yet the specific documentation needed to support a request is often incomplete, buried in records, or discovered only after a submission has already stalled.
Incomplete evidence
Clinical notes may not include the exact history, duration, outcome, severity measure, or attachment required for a complete review.
Reactive workflows
Teams often learn what is missing after a pend, denial, or manual follow-up instead of resolving the gap at the start.
The platform vision
Clarity across the authorization journey.
Clariq is designed as a connected intelligence layer. The initial focus is readiness: translating applicable criteria into transparent, actionable pre-submission guidance.
1
Coverage Intelligence
Organize payer rules and documentation requirements into a searchable source of truth.
- Criteria normalization
- Step therapy
- Policy versioning
2
Workflow Connectivity
Prepare for secure connections to provider and pharmacy workflows over time.
- Case intake
- Document exchange
- Integration roadmap
3
Readiness Intelligence
Map available evidence to applicable criteria and show exactly what needs attention.
- Gap detection
- Readiness scoring
- Next-best actions
4
Denial Intelligence
Identify recurring workflow signals that can inform prevention and appeal strategy.
- Reason trends
- Case patterns
- Review support
5
Operational Intelligence
Help teams understand volume, recurring gaps, and improvement opportunities.
- Performance views
- Gap analytics
- Operational reporting
Interactive product demonstration
See the readiness workflow in action.
Explore a fictional specialty-therapy case. This prototype demonstrates how Clariq can make requirements, evidence gaps, and next steps easier to understand before submission.
Clariq Readiness Analyzer
No PHI / no live payer dataFictional data only · Sample coverage criteria · Human review required
1Choose a case
2Review criteria
3Resolve gaps
Choose a fictional sample case
Sample policy criteria
PlanSample Health Plan PPO
BenefitPharmacy
TherapyDemo Specialty Therapy
PolicySample v1.0
Qualifying diagnosisMetIncluded in fictional sample case.
Prior therapy requirementPartialPrior therapy named; response is not documented.
Trial durationMissingNo treatment start or end dates supplied.
Baseline severity evidenceMissingRequired measure not attached in the sample file.
Prescriber documentationMetSigned sample note available for review.
68/ 100
Needs evidence
Resolve the highlighted requirements before operational and clinical review.
Recommended action plan
Hard stop: prior therapy requirement cannot yet be verified from the available sample documentation.
Request a provider note or addendum documenting prior therapy name, dose, treatment dates, response, and discontinuation reason. Attach the applicable baseline severity evidence.
Editable outreach draft
To complete the prior authorization review, please provide documentation of the prior therapy trial, including medication name, dose, treatment start and end dates, treatment response, and reason for discontinuation. Please also include the applicable baseline severity assessment or supporting clinical evidence.
Demo notice: This draft is based on fictional sample data and requires human review before use.
Demo notice: This draft is based on fictional sample data and requires human review before use.
Designed around real workflows
Built for teams managing complex access work.
Specialty pharmacies
Bring consistency to benefits-verification and PA readiness workflows before a case moves to submission.
- Standardize documentation review across teams
- Focus follow-up on the specific evidence that is missing
- Track recurring gap patterns across fictional or future customer case populations
Provider offices and patient-access teams
Turn ambiguous payer requirements into clear, role-specific requests that are easier for clinical teams to complete.
- Clarify what the record needs to support
- Reduce unclear back-and-forth with administrative teams
- Prepare a review-ready submission package
Early access and product conversations
See what clarity before submission could look like for your workflow.
Request a conversation about Clariq Health. This form currently creates a front-end confirmation only; connect it to a scheduling or CRM service before publishing it as a live lead form.
Never submit patient information, PHI, payer credentials, or confidential case material through this public form.