Transparent and cost effective UM* reviews
Faster, better, cheaper fully outsourced UM services with real time reporting and transparent audit trails. Start complying with regulations now (CMS-0057F, state-specific) while managing your population effectively.
*Process used by healthcare payers and providers to evaluate the necessity, appropriateness, and efficiency of medical services, procedures, and facilities. UM typically includes prior authorization, concurrent review, retrospective review, appeals, peer to peer review.
AI Powered Utilization Management Services for UM teams across the united States
Manual prior authorization processes are no longer viable
Delayed case processing leads to costly fines
Manual reviews drive up operational expenses
Evolving regulations increase the risk of errors
Time-consuming paperwork causes stress and fatigue
ClarityCare provides a first pass review at all your prior authorization requests with AI
Guaranteed 1 business day turnaround time
ClarityCare allows you to meet any state/federal regulation and internal deadlines with ease. We have shown that it increases provider satisfaction by 65%.
Your data processed with peace of mind
ClarityCare keeps you in line with the latest healthcare regulations by continuously monitoring compliance across all your operations. The platform also offers top-tier data protection, meeting the stringent SOC-2 standards, so you can confidently manage sensitive patient information and reduce the risk of breaches or legal issues, ensuring that both your practice and patients are fully protected.
$55 flat fee for any service request
We have a simple pricing model: $55 per case. This includes prior authorization, appeals, peer to peer across outpatient, specialty drugs, radiation oncology, genetic testing, DMEPOS, elective surgeries, home health, behavioral health, rehabilitation services imaging, diagnostic tests.
Real time reporting & transparent audit trails
ClarityCare shares with your organization all of the key data in real time to help you engage with your population earlier. Prior authorization data is the most real time data you can ever get about a member. We help you make the most of it to improve member satisfaction today.
FAQs
Find answers to commonly asked questions about our services and solutions.
ClarityCare uses the most up to date industry standard evidence based guidelines to provide evidence driven decisions.
Implementation is quick and efficient, all ClarityCare needs is user access to your UM platform and start assigning it cases.
ClarityCare guarantees turn around time of under 24 hours, provides an audit trail of the decisions that were made as well as a dashboard to monitor all of these metrics real time.
Dashboard is available within the ClarityCare AI platform as well as exports and APIs are available. We expose status, turnaround time, decision reason, guideline cited.
We credit the full $55 fee and escalate the case for priority completion—your deadlines stay protected.