Prior Authorization Platform
Pre-auths, finally
out of the way.
Klivira submits, tracks, and resolves prior authorizations across every payer—right from your EMR. Starting with Epic.
Detect
Klivira reads orders directly from the EMR and identifies which require pre-auth, by payer and CPT.
Submit
We auto-fill and submit through CoverMyMeds, Availity, eviCore, Cohere, Carelon, RadMD and more.
Resolve
Status, denials, and approvals stream back into the chart. No portal logins, no faxes.
Detection engine
Catches what your coordinators miss.
Klivira reads every new order as it lands in the EMR and decides — in milliseconds — whether it needs a prior auth, which payer rule applies, and which channel to route through. The rule library is maintained per-payer and updated as policies change.
- Live rules engine evaluating payer + CPT + ICD-10 combinations
- Catches policy edge cases (failed conservative therapy, age limits, site-of-service)
- Flags expirations, plan changes, and re-auth windows before they bite
Auto-submission
One order. Every channel that matters.
Each payer wants the request in a different place — CoverMyMeds for pharmacy, eviCore for imaging, Cohere for surgical, fax for the VA. Klivira fills the right form, attaches the right notes, and sends it on, then watches for the response.
- 40+ portal integrations with credentialed automation, not screen scraping
- Paper-only payers handled via tracked fax with delivery confirmation
- Attaches the right clinical notes automatically — labs, imaging, progress notes
EMR Native
Lives inside your EMR. Starting with Epic.
Klivira embeds via SMART on FHIR. Coordinators trigger and review pre-auths without ever leaving the patient chart. Cerner, Athena, and Meditech follow.
- SMART on FHIR launch from any order
- Bidirectional sync of status, notes, and attachments
- Auto-routes paper-only payers to fax with tracked delivery
Denial intelligence
Denials, parsed and classified the second they land.
Most denials are recoverable — they just take days to act on because the actual reason is buried in a PDF or a payer letter. Klivira reads the response, extracts the reason, classifies it, and queues the right response automatically.
- NLP-driven denial parsing across portal, fax, and 835 responses
- Classifies recoverable vs. medical-necessity denials separately
- Pre-fills the resubmission packet with the missing field flagged for review
Missing documentation of failed conservative therapy (PT, NSAIDs, or rest) in the past 6 weeks.
- → Request conservative therapy notes from PCP
- → Attach to original auth packet
- → Resubmit to eviCore on receipt
Analytics & insights
See what your authorizations are actually doing.
Every health system has the same questions — which payers are slow, which service lines drive denials, where the queue is backing up — and no clean way to answer them. Klivira gives you the dashboard, the export, and the alert rules.
- Auto-approval rates, denial categories, and time-to-decision by payer
- Drill down to the service-line and individual provider level
- Configurable alerts for SLA breach, denial spike, or queue depth
Coverage
Every payer. Every workflow.
From CoverMyMeds and Availity to eviCore, Cohere, Carelon, RadMD, Accredo, and the paper VA forms — 33 service lines, grouped into the workflows your team actually thinks in.
Pharmacy & Specialty Drugs
PBM ePA, specialty enrollment, and benefits investigation across every major pharmacy channel.
Infusion & Injectables
Medical-benefit infusions, J-codes, and buy-and-bill coordination — including Botox and Dysport.
Behavioral Health
TMS, Spravato/Esketamine, and outpatient psychiatry authorizations across commercial and Medicare.
Imaging & Diagnostics
Advanced imaging, genetic and molecular testing, and cardiology imaging authorizations.
Oncology
Chemotherapy, immunotherapy, radiation oncology, and oncology pathway prior authorizations.
Surgical & Procedural
Inpatient and outpatient procedures across BCBS, UHC, Aetna, Humana, Tricare, and VA.
Outpatient Specialty
Biologics and procedure-level PAs across the medical specialties driving the highest auth volume.
Therapy, DME & Post-Acute
Physical/occupational therapy, chiropractic, durable medical equipment, home health, and multi-payer portals.
Why Klivira
From a process that breaks to one that holds.
Prior auth is a system problem, not a staffing problem. Klivira fixes the system.
Without Klivira
Manual portals, faxes, phone calls
- Coordinators juggle 6+ payer portals, faxes, and phone trees per shift
- Order falls through the cracks for days before anyone notices
- Denial reasons buried in PDFs — re-submission takes another week
- Authorization status lives outside the chart, in someone's spreadsheet
With Klivira
One automated loop, inside your EMR
- One inbox in the EMR — every pending auth, surfaced the moment an order is placed
- Submission happens in under four minutes, with the right form for the right payer
- Denials parsed automatically, with a queued response and missing-info checklist
- Status and attachments write back to the chart, available to every clinician on the team
Built for the people who do this work
One platform. Four very different jobs.
Stop context-switching between six portals. Work the queue, not the tabs.
- One unified inbox across every payer channel
- Denials with the actual reason already parsed
- Templated re-submission with one click
Quantify the bottleneck and watch it shrink. Every auth, end-to-end, in one ledger.
- Auto-approval rate, denial drivers, payer SLAs
- Time-to-decision tracked from order to resolution
- Exportable for board-level reporting
Get back to patients. Klivira asks only when it actually needs you.
- Smart prompts only when documentation is missing
- Status surfaces in the chart, not in your inbox
- Peer-to-peer scheduling triggered automatically
SMART on FHIR, HIPAA-aligned, SOC 2 in progress. Built to clear your security review.
- Standards-based EMR integration — no scraping
- Tenant isolation and per-customer key management
- Full audit trail, exportable for compliance
Security & Compliance
Built to clear hospital security review.
Klivira handles PHI on the same workflow that handles patient orders. We treat security and compliance as a product surface, not an afterthought.
HIPAA-aligned by design
PHI is encrypted in transit (TLS 1.3) and at rest (AES-256). BAA available for every customer.
SOC 2 Type II in progress
External audit underway. Continuous monitoring through Vanta. Policies and evidence available under NDA.
Least-privilege access
Role-based access controls map to Epic security classes. No shared credentials, ever.
Full audit trail
Every action — read, submit, approve, deny — is logged with user, timestamp, and payload. Exportable on demand.
Credential vaulting
Payer portal credentials are stored in an isolated vault with per-tenant encryption keys. Rotated automatically.
Tenant isolation
Each health system gets its own database schema. No cross-tenant data path exists in the application.
FAQ
Questions buyers usually ask.
Which EMRs do you support today?
Epic is live via SMART on FHIR, launching from any order. Cerner, Athena, and Meditech are on the near-term roadmap. eClinicalWorks and NextGen follow.
How do you handle PHI?
Klivira is HIPAA-aligned with a BAA available for every customer. PHI is encrypted in transit (TLS 1.3) and at rest (AES-256), and we use tenant-isolated schemas so no cross-customer data path exists. SOC 2 Type II audit is in progress.
What if a payer doesn't have a portal?
Paper-only payers are auto-routed to fax with tracked delivery confirmation. We maintain a per-payer playbook so each request goes to the right channel, including the few payers that still want phone calls.
How long does implementation take?
For a single-clinic Epic deployment, most customers are live in two to four weeks. Multi-site health systems typically run a six-week phased rollout. We handle the SMART on FHIR registration, payer credential capture, and clinical workflow configuration in parallel.
How is Klivira priced?
Per-provider monthly subscription, with volume tiers for health systems and a fixed implementation fee. Pricing is structured so the platform pays for itself inside the first quarter on coordinator time alone — happy to share specifics on a demo call.
What happens to an in-flight authorization if it's denied?
Klivira parses the denial reason from the payer response (or fax), classifies whether it's a missing-data issue or a medical-necessity issue, and queues a re-submission with the missing fields surfaced for the clinician. No more digging through PDFs for the actual reason.
Give your team back their week.
See how Klivira can eliminate hours of pre-auth busywork from your clinic or hospital.