Platform Overview

Every PA touchpoint,
automated.

From EHR data pull to payer submission to patient notification — Navistrada handles the entire prior authorization workflow so your coordinators can focus on patients, not payer portals.

8 min
Per Submission
vs. 90 min manually
91%
AI Approval Rate
vs. 68% industry baseline
21
API Endpoints
full PA & Rx workflow
6
Live Integrations
eCW, Availity, Change HC, and more
How It Works

From chart to approval
in 8 minutes.

Not a portal. Not a form filler. A complete clinical intelligence layer that handles the full authorization lifecycle — automatically.

EHR Integration

Your chart feeds Navistrada.
Not the other way around.

No double entry. No copy-paste. Navistrada connects to eClinicalWorks via FHIR R4 and pulls everything the payer needs in under 1.5 seconds. Your coordinator never touches a keyboard for data already in the chart.

  • 8 FHIR queries run in parallel — patient, conditions, medications, labs, insurance, encounters — all at once
  • Lab values extracted by LOINC code — CRP, ESR, hemoglobin, ferritin — with dates automatically calculated
  • Medication history with treatment durations computed — no guesswork on how long the patient was on MTX
  • Authorization outcomes written back to the patient chart — automatic audit trail, zero manual documentation
Live EHR Pull — 1.4 seconds
PatientMargaret Johnson · F/56
DiagnosisM05.79
Step TherapyMTX 2.5 mg ✓
CoverageAetna PPO · W123456789
BMI34.2 — attestation queued
Total pull time1.4 seconds
Payer Intelligence

Knows what payers want
before they ask for it.

Every payer has policies not in their published LCDs — discovered through denials. Navistrada has catalogued real-world payer behavior across commercial plans and applies that intelligence to every submission automatically.

  • Detects step therapy conflicts before submission — not after denial
  • Applies continuity-of-care exceptions automatically for established biologic patients
  • Surfaces undocumented patterns — Cigna's BMI rule, BCBS TX's imaging requirement, Humana's biosimilar policy change
  • 91% first-pass approval — 23 percentage points above the industry baseline
AI Policy Analysis · J0202 · United HC
67%
Before exception · UHC biosimilar conflict detected
UHC biosimilar-first policy applies — adalimumab-atto required
Continuity of care exception: patient on brand >14 months — auto-applied
6 prior approvals with identical exception in submission history
After exception applied
89%
Patient Notification

Your patient shows up
already authorized.

The moment a payer approves, Navistrada texts your patient with the auth number, facility, estimated cost, and prep instructions. The imaging center gets a pre-verification fax. No phone calls. No day-of confusion.

  • Instant SMS on approval — auth number, facility address, patient cost estimate
  • Imaging center fax with auth pre-verified — no phone call needed on arrival
  • 48-hour appointment reminder automatically scheduled after approval
  • TCPA-compliant consent management built into the workflow
Navistrada · Patient Navigate

Hi Margaret, your MRI has been approved by Aetna. Auth #: AUT-2025-88471. Valid through June 15.

10:42 AM

Your MRI is at Memorial Imaging, 4800 Westover Dr. Arrive 15 min early. Auth pre-verified — no phone call needed. Est. cost: $180.

10:44 AM ✓✓

Imaging center faxed · No callback needed
Specialty Intelligence

Navistrada doesn't submit PAs.
It knows your payers' playbook.

The policies that matter most aren't published. They're discovered through denials. Navistrada has already learned them.

01 — Rheumatology
Biologics · DMARDs · Step Therapy
  • Aetna: 3-month DMARD trial. BCBS TX: 6 months. Documentation formatted per payer automatically.
  • UHC biosimilar-first policy: AI detects and applies continuity-of-care exception for existing patients.
  • Humana 2025 policy change: biosimilar protocol exception logic built in before most practices knew.
  • Cigna undocumented BMI denial pattern at BMI ≥ 40: weight counseling note added automatically.
02 — Nephrology
ESAs · IV Iron · Calcimimetics
  • CMS requires hemoglobin below 10 g/dL for ESA initiation. Lab must be within 30 days — stale values flagged before submission.
  • TSAT below 20% or ferritin below 200 (dialysis) / 100 (non-dialysis) — extracted directly from EHR labs by LOINC code.
  • PTH and phosphorus values pulled and formatted per payer requirements for calcimimetic authorization.
  • Dialysis vs. non-dialysis status identified automatically. Medicare vs. commercial criteria applied correctly.
03 — Gastroenterology
IBD Biologics · HCV Antivirals · Colonoscopy
  • IBD biologic step therapy hierarchy per payer — Entyvio, Stelara, Skyrizi, Remicade — applied automatically.
  • HCV genotype pulled from labs. Mavyret vs. Epclusa vs. Harvoni selection is genotype-driven — no manual lookup.
  • BCBS TX 2024 colonoscopy policy update: new PA requirements incorporated immediately when the policy changed.
  • CDAI and Mayo scores extracted from structured data or progress notes via AI for disease activity evidence.
How We Compare

The only platform built
for specialty medicine.

Generic RCM platforms added a PA module. Navistrada was built from the ground up by a specialty physician who does this work every day.

Capability Navistrada Cohere Health Olive AI Availity Portal Waystar
FHIR R4 EHR auto-pull — zero manual entry
Specialty clinical AI — Rheum, Neph, GI
Proprietary payer policy intelligence
Patient SMS notification on approval
Full Rx pathway — DUR, PDMP, NCPDP SCRIPT
Biologic renewal queue — automatic expiry alerts
SMB specialty practice pricing

✓ Full   ◐ Partial   ✗ Not available · Based on public documentation as of Q2 2026.

Integrations

Plugs into the systems
you already use.

No rip-and-replace. Your coordinators keep working in eClinicalWorks — Navistrada works in the background.

eClinicalWorks · FHIR R4
Availity · X12 278 ePA
Change Healthcare
CoverMyMeds ePA
Surescripts · NCPDP
Anthropic Claude AI
Twilio SMS
First Databank DUR
PMP InterConnect TX

HL7 FHIR R4 · HIPAA compliant · TCPA-compliant SMS · SOC 2 Type II in progress

Ready to see it?

Your first authorization
submitted in under 8 minutes.

Schedule a 30-minute live walkthrough. We'll show you exactly what your coordinator's morning looks like when Navistrada handles the paperwork.

HIPAA Compliant eCW FHIR Integrated SOC 2 In Progress Built by Clinicians 90-Day Guarantee