AI Agents for Utilization Management

Input to review. Fully automated.

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HIPAA CompliantSOC 2 Type IIEnterprise Ready
One case, end to end

Request in. Recommendation ready.

See Electra process a knee MRI case with every citation attached.

  1. 01

    Intake

    Request received

    Every channel becomes one case.

    • Request
    • Clinical notes
    • Benefits
  2. 02

    Organize

    Inputs organized

    Member, PA, and documents are organized.

    • Member matched
    • PA confirmed
    • Files classified
  3. 03

    Evaluate

    Evidence reviewed

    Criteria and benefits are checked together.

    • Criteria checked
    • Benefits verified
    • Exceptions flagged
  4. 04

    Deliver

    Recommendation ready

    Rationale and audit trail are ready for review.

    • Recommendation
    • Cited rationale
    • Audit trail
Why Electra

Enterprise-grade AI built for healthcare

  • Faster Than Humanly Possible

    Electra agents process prior authorizations in minutes, not days. Meet every CMS and state turnaround requirement with ease.

  • Always Audit-Ready

    Every agent logs its reasoning, cites guidelines, and ensures full CMS-0057-F and NCQA compliance. SOC-2 certified and HIPAA-secure.

  • Scale Without Hiring

    Each enhanced nurse can oversee the output of 6-8 agentic FTEs. Reduce operating costs while maintaining complete oversight.

  • Plug-and-Play Workforce

    Agents integrate seamlessly into your UM systems and are onboarded like your staff using your existing access and policies.

Proven results

Measured impact.

700k+

patients supported

Clinician aligned

97%

Approval match

AI-to-clinician alignment

Processing time
3min

per case

~17 min standard
Turnaround
2days

median

2 days faster
Work automated
90%

of the workflow

End-to-end UR
Expand your capabilities

Beyond cost containment operations

ClarityCare's agentic workforce expands across your healthcare operations.

Payment Integrity

Claims and denial reviews

Clinical Programs

Care management, risk adjustment, and transitions of care

Population Analytics

Real-time member insights derived from prior authorization data

Early signal
Prior authorization data is your earliest signal of member risk. Electra helps you act on it, instantly.
FAQ

Everything you need to know

Search the questions teams ask most, or browse the essentials below.

Electra isn't a tool. It's a trained agent. It reads documents, applies guidelines, writes rationales, and learns under expert supervision.

See Electra in action

Ready to see it in action?

Schedule a demo to see how Electra transforms your UM operations.

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