Built for Community Oncology

Prior Authorization That Fights for Your Patients

Payers deny cancer treatments that should be approved — and count on your staff being too busy to fight back. VerityAuth is how your practice fights back. Faster approvals, automatic appeals, and zero patients left behind.

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All 6 PA types — drug, imaging, radiation, procedure, device, supportive care
Live in under 24 hours — no EHR integration required
HIPAA compliant — BAA included, SOC 2 infrastructure
88%
of PA denials are never appealed
80%
of appeals succeed when filed
⏳
The patient waits. Treatment delayed. Second-choice drug substituted. Outcomes worsen.
🔥
Your staff absorbs it. 30 PAs in the queue. No time to appeal. The denial stands.
💸
Revenue walks out. $10K–$50K per denial — written off because nobody had time to fight it.

The gap between these two numbers is the entire broken system in one stat. VerityAuth closes it.

KFF Medicare Advantage Analysis, 2024
AMA Prior Authorization Physician Survey, 2024
ASCO Policy Statement on PA
Denial by Design

The System Isn’t Broken by Accident. It’s Working Exactly as Payers Intended.

When a PA is denied, 88% of the time nobody appeals — not because the denial is clinically justified, but because your coordinator has 30 other PAs in her queue and no time to draft a letter, pull NCCN citations, and sit on hold with a medical director. The payers know this. Denial isn’t a clinical decision. It’s a bet that your practice won’t fight back. KFF, 2024

And the bet pays off. 80% of appeals succeed when someone actually files one. That means the vast majority of denied treatments should have been approved in the first place. Every unappealed denial is a patient who doesn’t get the drug their oncologist prescribed — not because it wasn’t medically necessary, but because the system made it too hard to prove what everyone already knows. AMA, 2024

The downstream cost is devastating. 93% of oncologists report patients being forced onto second-choice therapies because of PA. Cancer Therapy Advisor One in three radiation oncologists says PA has caused patients to abandon treatment entirely. ASTRO, 2023 And research from Johns Hopkins shows that even 1–3 week delays in starting guideline-based cancer treatment correlate with worse disease control and lower survival rates. Johns Hopkins Medicine

Meanwhile, your coordinators spend 12+ hours per week navigating payer portals, chasing faxes, and sitting on hold — for authorizations that are approved the vast majority of the time anyway. The admin burden isn’t just annoying. It’s the reason nobody has time to appeal.

Your practice absorbs this three ways: your staff is overworked and burning out, your patients aren’t getting the treatment you prescribed, and $10K–$50K per denial walks out the door every time nobody files an appeal. That’s not an appeal problem. That’s the entire broken system — and VerityAuth fixes every layer of it.

Why Oncology

This Problem Hits Oncology Harder Than Any Other Specialty

Every specialty deals with PA. But in oncology, the stakes are measured in survival, not inconvenience. 97% of radiation treatments and the vast majority of infusion drugs require PA. A single cancer patient needs PAs for drugs, imaging, radiation, procedures, devices, and supportive care — that’s 6–15 separate authorization events across their treatment journey. Each one is a chance for a denial that nobody has time to appeal.

92% of radiation oncologists report PA-caused treatment delays. ASTRO, 2023 Generic PA tools treat a Keytruda auth the same as an MRI for back pain. Your patients are on treatment timelines measured in days, not months — and when a denial goes uncontested, the delay isn’t administrative. It’s clinical.

VerityAuth was built by people who’ve lived inside the PA system maze for over a decade — on the provider side, the technology side, and the payer side. We didn’t build a generic tool and bolt on oncology. We built for oncology first, because your patients can’t wait.

NCCN Guideline Intelligence

AI matches regimens to current NCCN guidelines with evidence level and category citations.

Regimen-Aware Processing

Understands multi-drug regimens, lines of therapy, and step therapy requirements specific to oncology.

Clinical Trial Matching

When a denial stands, AI searches ClinicalTrials.gov for eligible trials — turning a dead end into an alternative path.

Built for Community Practices

Designed for the 3–15 provider groups that treat the majority of cancer patients but get ignored by enterprise vendors.

97%
of radiation oncology
requires PA
ASTRO, 2023
75%
of new drug approvals
are specialty
IQVIA, 2024
93%
of oncologists report
forced substitutions
Cancer Therapy Advisor
1–3 wk
delays linked to worse
disease control
Johns Hopkins Medicine
The VerityAuth Workflow

5 Steps. 5 Minutes. Every Denial Fought.

Every oncology PA — drug, imaging, radiation, procedure, device, supportive care — follows the same streamlined path. Because getting it right the first time matters most when the alternative is a denial nobody has time to appeal.

MG

Maria Garcia

Stage IIIA NSCLC · Cigna PPO · PD-L1 65%
Drug PA Imaging PA Radiation PA
1
Start the PA
30 seconds

Select the PA type, patient, and payer. AI handles the rest.

A single cancer patient needs PAs for drugs, imaging, radiation, procedures, devices, and supportive care. VerityAuth handles all 6 with category-specific clinical forms. Related PAs auto-link and pre-fill from each other — because every resubmission is another delay a cancer patient can’t afford.

You do: Select PA category, pick patient, confirm payer
AI does: Auto-populates demographics, insurance, diagnosis from patient profile. Links related PAs and pre-fills from prior auths.
Patient gets: The right PA type submitted the first time — no back-and-forth, no resubmissions, no days lost.
Select PA Type
Drug
Imaging
Radiation
Procedure
Device
Supportive
2
Check Benefits & Alternatives
10 seconds

Before you enter the PA maze, check whether you can skip it entirely.

Before your coordinator spends 45 minutes on paperwork that might end in a denial nobody appeals, VerityAuth checks benefits in real time. Coverage confirmed, PA required — but the AI also flags clinically equivalent drugs the payer covers without PA. When the alternative is a fight the system is designed for you to lose, avoiding the fight altogether is the smartest move.

You do: Select drug, confirm patient’s payer
AI does: Real-time eligibility check across 3,400+ payers. Surfaces PA-free alternatives with NCCN equivalence.
Patient gets: If a PA-free option exists, treatment can start today. No waiting. No risk of denial.
Benefits Verification
Cigna • Maria Garcia
Coverage StatusActive
Keytruda (J9271)PA Required
Benefit TypeMedical (Part B)
Copay20% after deductible
PA-Free Alternative Found
Tecentriq (atezolizumab) covers the same NSCLC indication under this payer’s formulary. No PA required.
NCCN Category 1 • Same indication
3
AI Prepares Your Case
Instant

AI fills the form, matches NCCN guidelines, and maximizes first-pass approval.

Instead of manually entering 30+ fields, the AI pre-populates everything from the clinical profile, then checks it against payer criteria and NCCN guidelines. You see approval probability, documentation gaps, and evidence citations before you submit.

Getting it right the first time isn’t just convenient — if this PA gets denied, there’s an 88% chance nobody will have the time to appeal it.

You do: Confirm diagnosis, treatment plan, and clinical details. Fix any flagged gaps.
AI does: Auto-fills all fields. Matches regimen to NCCN guidelines with citations. Scores approval probability. Flags missing documentation.
Patient gets: First-pass approval rate maximized. No rejections for incomplete paperwork.
Clinical Intelligence
Keytruda · Cigna
Approval Probability72%
NCCN MatchNSCLC Cat 1
Gaps Found2
Payer RequiresPD-L1 ≥ 50%
4
Track & Coordinate
Ongoing

Your entire PA operation in one place.

This is where coordinators spend 70% of their time — and why they don’t have time to appeal denials. VerityAuth replaces the spreadsheets, sticky notes, and “did you hear back?” conversations with a command center that tracks every call, fax, and status change automatically. When tracking is effortless, your team has capacity to do the work that actually recovers revenue: fighting denials.

You do: Work your queue. Log calls, faxes, and updates with one-click quick actions.
AI does: Auto-timestamps everything. Surfaces follow-up reminders. Tracks aging PAs and flags deadlines.
Patient gets: Nothing forgotten. Every PA tracked to resolution with a complete audit trail.
Activity Log
Maria Garcia
Sarah called payer — decision expected Friday
2:14 PM
System — status changed to In Review
9:30 AM
Sarah faxed docs, set Thursday reminder
Yesterday
AI flagged 2 gaps — PD-L1 and prior therapy
Mon
5
Denial → Appeal → Resolution
2 minutes

88% of denials go uncontested. VerityAuth fights every one.

Your practice has 6–10 denials a month. Today, maybe 1 gets appealed. With VerityAuth, all of them do. The system generates an NCCN-cited appeal letter and P2P talking points in 2 minutes. At $10K–$50K per denial and an 80% overturn rate, that’s the ROI conversation in one sentence.

And if the appeal is also denied? VerityAuth has already matched the patient to eligible clinical trials on ClinicalTrials.gov — turning a dead end into an alternative path the patient wouldn’t have found otherwise.

You do: Click “Generate Appeal.” Review the letter. Send it.
AI does: Writes NCCN-cited appeal letter. Generates P2P talking points for the physician. Tracks appeal deadline. If the appeal fails, surfaces matched clinical trials scored by eligibility.
Patient gets: Every denial fought. The prescribed treatment when the appeal wins — or a clinical trial alternative when it doesn’t. No dead ends.
AI Appeal Letter
80% overturn rate
Keytruda (Pembrolizumab) — Appeal
3 NCCN citations · P2P points · 2 trial matches
Step 1 of 5
Your Practice, Your Way

One Platform That Meets Your Practice Where You Are

Every practice runs PA differently. Maybe you have a dedicated coordinator, maybe your office manager handles it, maybe the clinician is doing it all. VerityAuth adapts to how your team actually works.

The PA Coordinator

Day-to-day PA workflow

The Practice Leader

Operations & revenue oversight

The Clinician

Clinical decisions & patient care

Sarah Johnson — PA Coordinator

Handle Twice the Volume. Lose Zero PAs.

Whether it’s a dedicated coordinator or the office manager wearing another hat, whoever handles your day-to-day PAs is juggling 30+ active cases across multiple payers. Their day is phone calls, fax follow-ups, and status tracking — the same work that makes it impossible to appeal denials. VerityAuth gives them a command center that replaces the spreadsheet, the sticky notes, and the mental juggling — so when a denial comes in, they have the time and the tools to fight it.

Smart queue with urgency scoring, follow-up reminders, and aging alerts
One-click activity logging — calls, faxes, status changes tracked automatically
AI-generated appeals in 2 minutes — no more watching denials expire
Patient view groups all PAs for one patient — drug, imaging, radiation — in one place
VerityAuth PA Queue showing denied PA with authorization timeline, next action banner, and Generate Appeal button
Patient list with risk indicators and multi-PA grouping
Patient View

All PAs for one patient grouped together. Risk indicators, active cases, and diagnosis at a glance.

Activity log showing calls, notes, and status changes with timestamps
Activity Log

Full timeline for every PA. Who called, when, what happened. No more “did we hear back?”

Appeal workflow showing case analysis, success likelihood, and Generate Appeal Letter button
Appeal Generator

AI analyzes the denial, scores success likelihood, builds the case, and writes the letter. You click send.

Karen Mitchell — Office Manager

See Where You’re Losing Revenue. Recover It.

Someone in your practice needs the big picture: are we keeping up? Who’s overloaded? Which payers are slow? Whether that’s an office manager, a practice administrator, or the lead physician — they need to answer one question above all: how much revenue are we losing to unappealed denials? VerityAuth answers it in real time and gives them the tools to turn lost revenue into recovered revenue.

Revenue recovery dashboard — denials, appeals filed, overturns, dollars recovered
Team workload view — PA volume, response times, coordinator capacity
Payer analytics — approval rates, turnaround times, denial patterns by payer
ROI reports — show the board exactly what VerityAuth is delivering in hard dollars
Team Dashboard showing workload overview, coordinator productivity, payer turnaround analytics, and practice ROI
Practice ROI dashboard showing net ROI, denials recovered, labor savings, and annual projection
Revenue Recovery

Denials recovered, labor savings, ROI multiple, annual projections. The math that justifies the investment.

Team performance showing coordinator workload, completion rates, and turnaround analytics
Team Performance

PA volume by coordinator, average turnaround, workload distribution. Staff where the volume is.

Gold Card analytics showing payer approval rates across all PA categories
Payer Intelligence

Gold card tracking, approval rates by payer and category, and alerts when thresholds are at risk.

Dr. Lisa Chen — Oncologist

Your Patients Get the Treatment You Prescribed

Dr. Chen prescribes Keytruda because it’s the right drug for her patient. She shouldn’t have to wonder whether a payer will override her clinical judgment — and she definitely shouldn’t have to accept it when they do.

93% of oncologists report patients being forced onto second-choice therapy because of PA. Cancer Therapy Advisor Research shows that even 1–3 week delays in starting guideline-based treatment correlate with worse disease control and lower survival. Johns Hopkins Medicine

The system is overriding your clinical judgment, and your staff doesn’t have the time to fight back. VerityAuth fights back for you. Every denial appealed with NCCN-cited evidence. P2P talking points ready when the medical director calls. Your patients get what you prescribed — not what the payer’s algorithm substituted.

P2P prep in seconds — NCCN citations, patient history, and payer-specific talking points
Clinical trial matching — when a denial stands, alternative paths appear automatically
Treatment timeline — see exactly where each patient is in their PA journey
Forced substitution tracking — data showing how many patients received their prescribed treatment
Provider view showing Clinical Match tab with 89% approval probability, clinical criteria matching, and NCCN guideline evidence
Clinical criteria match showing met and partial criteria for approval probability scoring
P2P Preparation

Clinical criteria matching with evidence citations specific to the patient’s regimen, stage, and biomarkers.

Clinical trial matches with eligibility scoring, distance, and phase information
Clinical Trial Matches

Eligibility scoring, distance filtering, and one-click sharing when the appeal path closes.

Appeal case analysis showing strengths, weaknesses, and recommended strategy
Appeal Intelligence

Case strength analysis, key arguments, and evidence recommendations — so your P2P call is airtight.

The Impact

The ROI Math Is Simple. The Appeal Data Proves It.

You don’t need hypothetical projections when you have the data. Your practice has denials every month that nobody appeals. VerityAuth appeals all of them. The numbers do the rest.

Estimated Monthly Revenue Recovery
$48K–$200K
per practice, from appeals alone
6–10 denials/mo × 80% overturn × $10K–$50K each
🩺
Clinical Impact
Zero
unappealed denials. Patients get the treatment you prescribed, not the payer’s substitution.
⚡
Operational Impact
9x
coordinator capacity. 5 min per PA instead of 45. Staff has time to appeal, not just process.
Average oncology denials per month 6–10 per practice
Denials currently appealed Less than 12%
Revenue at risk per unappealed denial $10K–$50K
Appeal success rate with clinical evidence 80%+
Avg time per PA (manual process) 45 min
Avg time per PA (with VerityAuth) 5 min
Result Every denial fought. Revenue recovered.
⚡

One Overturned Denial Pays for a Year of VerityAuth

A single $35K appeal win covers the entire annual subscription. Everything after that is pure recovered revenue your practice was writing off before.

🩺

The Impact You Can’t Put a Dollar On

Every overturned denial is a patient who receives the treatment their oncologist actually prescribed — not the second-choice therapy the payer substituted. That’s the outcome that matters most.

When the Appeal Fails

Denied Drug? Find a Clinical Trial in Seconds

Even with an 80% overturn rate, some denials stand. VerityAuth doesn’t let that be a dead end. The system automatically searches ClinicalTrials.gov for relevant trials and scores each by patient eligibility — turning a closed door into an alternative path.

Eligibility match scoring (e.g., 87% Strong Match, 8/11 criteria met)
Filter by distance, trial phase, and recruiting status
Direct links to ClinicalTrials.gov, shareable results, and eligibility details
One-click from any denied PA — patient profile auto-populated
Clinical trial matching showing eligibility scores, trial phases, distance from practice, and ClinicalTrials.gov links
Get Started

Up and Running the Same Day

No installation, no EHR integration, no IT department required.

1

Sign Up & Configure

Create your practice profile, add your providers, and connect your payer portal credentials. No software to install — it’s a web app.

15 minutes
2

Select PA Type & Enter Details

Choose from Drug, Imaging, Radiation, Procedure, Device, or Supportive Care. Enter clinical details using category-specific forms. AI shows approval probability and required documentation.

5 minutes per PA
3

Track, Coordinate & Recover

Monitor every PA in one place. Follow-up reminders ensure nothing slips. If denied, AI generates the appeal letter and finds clinical trial alternatives. Every denial fought.

Automated

Everything Your Practice Needs — One Platform

Simple per-provider pricing. All features included. No tiers, no add-ons, no implementation fees.

What’s Included
AI clinical intelligence & NCCN matching
All 6 PA types (drug, imaging, radiation, procedure, device, supportive)
Related PA workflow with auto-fill
AI appeal generation with NCCN citations
Benefits verification across 3,400+ payers
Clinical trial matching from ClinicalTrials.gov
PA-free drug alternative detection
Gold card analytics by payer & category
Team coordination & activity logs
Supervisor dashboard & ROI reports
Patient view with multi-PA grouping
Role-based access (Supervisor, Coordinator, Provider)
Configurable queue models — Assigned, Pool, or Hybrid
Unlimited PA submissions
Standalone benefits verification
AI copilot for in-app questions
Start Your Free Pilot

30 days free. No credit card. No obligation.

FAQ

Common Questions

What oncology practices want to know before getting started.

Which payers do you support?

VerityAuth supports eligibility verification across 3,400+ payers through our Stedi integration. PA submissions work with all commercial payers and Medicare. We add payer-specific criteria as customers need them.

Do I need to integrate with my EHR?

No. VerityAuth is a standalone web application — no installation, no EHR integration, no IT involvement. Your staff logs in from any browser and starts submitting PAs immediately. EHR integration is on our v2 roadmap.

How is the AI different from other PA tools?

Most PA tools automate form-filling for drug PAs only. VerityAuth covers all 6 PA types with category-specific clinical forms, links related PAs so your staff enters patient data once, and includes a full coordination workspace — activity logs, follow-up reminders, team assignment, and supervisor dashboards with ROI tracking. The AI understands clinical content, matching regimens to NCCN guidelines, predicting approval likelihood, and generating evidence-based appeals.

Is my patient data safe?

Yes. All data is encrypted in transit (TLS 1.2+) and at rest (AES-256). We run on HIPAA-eligible AWS infrastructure and provide a signed BAA for every customer. We never use patient data to train AI models.

How does billing work?

Simple per-provider monthly subscription. All features included — no per-PA fees, no setup costs, no hidden charges. We’ll walk through pricing during your demo so we can tailor it to your practice size. The pilot period is completely free.

Can my staff use it without training?

Yes. The interface is intuitive — if your staff can use a payer portal, they can use VerityAuth. We also provide a guided onboarding session and an in-app AI copilot for questions.

What’s the CMS 2027 mandate I keep hearing about?

CMS is requiring payers to support electronic prior authorization by 2027. Practices that adopt electronic PA tools now will be ahead of the curve — and tools like VerityAuth will become essential infrastructure.

Does this actually help my patients, or is it just an admin tool?

Both — and that’s the point. Faster PA processing means faster treatment starts. Every denial gets appealed with NCCN-backed evidence, so patients get the drug you prescribed instead of a second-choice alternative. Clinical trial matching turns final denials into new options. And the platform tracks clinical impact from day one — turnaround time, forced substitutions avoided, appeals won.

Where does the appeal data come from?

The stats we cite — denial rates, appeal success rates, and clinical impact data — come from KFF’s Medicare Advantage analysis, the AMA’s Prior Authorization Physician Survey, ASCO policy statements, ASTRO surveys, and published research from Johns Hopkins Medicine. These are the most trusted sources in healthcare policy.

Get Started

Your Patients Can’t Wait. Neither Should You.

Every week without VerityAuth is another round of denials that go uncontested, revenue that walks out the door, and patients who don’t get the treatment you prescribed. Try the live demo or tell us about your practice.

Try Live Demo
or request a walkthrough

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