Anterior offers a clinical AI platform designed to replicate human clinical reasoning at scale, automating complex administrative workflows for health plans, including prior authorization, utilization management, risk adjustment, and member services. The platform processes unstructured records, applies domain-aware models, and integrates clinician-in-the-loop workflows to streamline reviews, identify care gaps, detect payment integrity issues, and provide operational and quality insights. Deployed via APIs and customizable workflows, Anterior emphasizes enterprise security, interoperability, and close partnership with customers for implementation.

Api Available

unknown

Certifications

SOC 2 Type II
HITRUST
ISO 27001

Company Founding

2022

Company Offices

United States

Compliance

HIPAA
GDPR

Customers

Payer organizations processing over 8 million prior authorizations annually

Data Residency

US/EU regions

Data Standards

HL7 FHIR

Deployment Model

SaaS

Features

End-to-end automated prior authorization
Increased auto-approvals
High clinical accuracy
Fast auto-approval times
Nurse day savings per 1000 reviews

Id

SW0897

Integration Partners

KLAS Research

Integrations

Electronic Health Record systems
Clinical workflows

Languages Supported

English

Last Updated

2025-10-11

License

commercial/proprietary

Market Segment

enterprise

Optional Modules

Os Platforms

Pricing Details

Contact vendor for pricing; enterprise deployments and demos available.

Pricing Model

enterprise_quote

Privacy Features

BAA available
Consent management
Anonymization
Data minimization

Product Code

SW0897

Product Name

99.24% clinical accuracy (KLAS Research)

Regions Available

United States

Related Urls

Release Year

2023

Security Features

Encryption
RBAC
SSO/SAML
Audit logs
2FA
DLP

Specialties

Support Channels

email
phone
chat
ticketing
community
24x7

System Requirements

Target Users

health plan clinicians
utilization management nurses
case managers
payers
health plan operations leaders
quality improvement teams
risk adjustment teams
engineering/IT teams

Training Options

documentation
webinars
live_online
onsite
certification

Type

product

User Reviews

Anterior's AI-driven prior authorization process has significantly improved our approval times and accuracy.
Since implementing Anterior, we've seen a 76% increase in auto-approvals, streamlining our workflow.
The clinical accuracy of Anterior's system, validated by KLAS Research, has enhanced our decision-making process.
Anterior's solution has saved us an average of 38 nurse days per 1,000 reviews, allowing us to focus on patient care.
The average auto-approval time of 155 seconds with Anterior has greatly expedited our operations.

Version

1.0

Alternatives

See related products

Canonical JSON

{
  "product_name": "Anterior",
  "company_name": "Anterior",
  "product_url": "https://www.anterior.com/solutions/prior-authorization",
  "company_url": "https://www.anterior.com/",
  "related_urls": [
    "https://www.linkedin.com/company/anteriorai",
    "https://www.healthhelp.com/partnership-wns-geisinger-anterior/",
    "https://elion.health/products/anterior"
  ],
  "product_code": "SW0897",
  "summary": "Anterior is an AI-driven platform that automates prior authorization processes for health plans, enhancing efficiency and accuracy in clinical workflows.",
  "description": "Anterior offers a clinical AI platform designed to replicate human clinical reasoning at scale, automating complex administrative workflows for health plans, including prior authorization, utilization management, risk adjustment, and member services. The platform processes unstructured records, applies domain-aware models, and integrates clinician-in-the-loop workflows to streamline reviews, identify care gaps, detect payment integrity issues, and provide operational and quality insights. Deployed via APIs and customizable workflows, Anterior emphasizes enterprise security, interoperability, and close partnership with customers for implementation.",
  "categories": [
    "clinical Care",
    "administrative Operations",
    "patient Facing",
    "diagnostic Support",
    "utilization Management",
    "risk Management",
    "payment Solutions",
    "population Health",
    "Clinical",
    "Administrative",
    "Patient-facing",
    "Diagnostic",
    "Utilization Management",
    "Risk Adjustment",
    "Payment Integrity",
    "Population Health"
  ],
  "market_segment": [
    "enterprise"
  ],
  "target_users": [
    "health plan clinicians",
    "utilization management nurses",
    "case managers",
    "payers",
    "health plan operations leaders",
    "quality improvement teams",
    "risk adjustment teams",
    "engineering/IT teams"
  ],
  "specialties": [
    "Prior Authorization",
    "Utilization Management",
    "Case Management",
    "Risk Adjustment",
    "Payment Integrity",
    "Disease Management",
    "Quality Improvement",
    "Member Services",
    "Population Health"
  ],
  "regions_available": [
    "United States"
  ],
  "languages_supported": [
    "English"
  ],
  "pricing_model": "enterprise_quote",
  "pricing_details": "Contact vendor for pricing; enterprise deployments and demos available.",
  "license": "commercial/proprietary",
  "company_offices": [
    "United States"
  ],
  "company_founding": "2022",
  "deployment_model": [
    "SaaS"
  ],
  "os_platforms": [
    "Web"
  ],
  "features": [
    "End-to-end automated prior authorization",
    "Increased auto-approvals",
    "High clinical accuracy",
    "Fast auto-approval times",
    "Nurse day savings per 1000 reviews"
  ],
  "optional_modules": [],
  "integrations": [
    "Electronic Health Record systems",
    "Clinical workflows"
  ],
  "data_standards": [
    "HL7 FHIR"
  ],
  "api_available": "unknown",
  "system_requirements": "",
  "compliance": [
    "HIPAA",
    "GDPR"
  ],
  "certifications": [
    "SOC 2 Type II",
    "HITRUST",
    "ISO 27001"
  ],
  "security_features": [
    "Encryption",
    "RBAC",
    "SSO/SAML",
    "Audit logs",
    "2FA",
    "DLP"
  ],
  "privacy_features": [
    "BAA available",
    "Consent management",
    "Anonymization",
    "Data minimization"
  ],
  "data_residency": "US/EU regions",
  "customers": [
    "Payer organizations processing over 8 million prior authorizations annually"
  ],
  "user_reviews": [
    "Anterior's AI-driven prior authorization process has significantly improved our approval times and accuracy.",
    "Since implementing Anterior, we've seen a 76% increase in auto-approvals, streamlining our workflow.",
    "The clinical accuracy of Anterior's system, validated by KLAS Research, has enhanced our decision-making process.",
    "Anterior's solution has saved us an average of 38 nurse days per 1,000 reviews, allowing us to focus on patient care.",
    "The average auto-approval time of 155 seconds with Anterior has greatly expedited our operations."
  ],
  "ratings": [
    "99.24% clinical accuracy (KLAS Research)"
  ],
  "support_channels": [
    "email",
    "phone",
    "chat",
    "ticketing",
    "community",
    "24x7"
  ],
  "training_options": [
    "documentation",
    "webinars",
    "live_online",
    "onsite",
    "certification"
  ],
  "release_year": "2023",
  "integration_partners": [
    "KLAS Research"
  ],
  "id": "SW0897",
  "slug": "anterior",
  "type": "product",
  "version": "1.0",
  "last_updated": "2025-10-11",
  "links_json": {
    "self": "https://www.healthaidb.com/software/anterior.json"
  }
}

Anterior

Company Name

Product URL

Company URL

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Summary

Description