Hiive delivers automated prior authorization and real-time benefits verification to specialty practices and medical device companies, with proven enterprise-grade technology at its core. Fewer delays, fewer denials, and a cleaner revenue cycle from day one.
Hiive's prior authorization automation solution removes the manual steps from the PA workflow, from eligibility check through submission, status tracking, and denial management. It connects to your existing clinical systems and payer networks without requiring a rip-and-replace implementation.
Delivered through a strategic partnership with enterprise-grade PA technology at its core, and implemented by Hiive's experienced healthcare delivery team.
what it does
Adapt
Surfaces denial patterns and recommends documentation improvements to reduce future denial rates
Prepare
Positioned for the CMS WISeR model (2026) — the AI-driven PA mandate for wound care products in Medicare FFS
Integrate
Integrates with major EHRs and no manual data re-entry is required
Extend
Pairs with Hiive AI Insights for end-to-end PA analytics and revenue cycle intelligence
Automate
Automates PA submission for specialty procedures, wound care products, DME, and medical devices — covering the payer relationships and clinical workflows where manual PA is most disruptive
built for
Hiive's real-time benefits verification solution delivers accurate, up-to-date eligibility and coverage intelligence before a procedure is scheduled, before a device is ordered, and before a claim is submitted. No more manual eligibility calls. No more coverage surprises at billing.
Delivered through a strategic partnership with enterprise-grade eligibility infrastructure, implemented by Hiive's healthcare delivery team and integrated into clinical and administrative workflows.
what it does
Verify
Verifies patient eligibility and specific benefit coverage in real time at the point of scheduling, referral, or order entry
Embed
Integrates with EHR and practice management systems to embed eligibility intelligence into the clinical workflow
Surface
Surfaces deductible status, copay and coinsurance details, coverage limitations, and active PA requirements in a single query, without manual portal lookup
Flag
Flags coverage gaps and payer-specific requirements for wound care products, specialty devices, and DME before they become billing problems
Trigger
Works in tandem with PA automation: eligibility confirmation triggers the PA submission workflow automatically where authorization is required
built for
