PA Checkpoint

JSON twin: https://www.healthaidb.com/software/pa-checkpoint.json

Company Name

Itiliti Health

Product URL

https://itilitihealth.com/products/pa-checkpoint

Company URL

https://itilitihealth.com

Categories

• administrative Operations
• clinical Decision Support
• data Integration
• compliance Management
• healthcare It
• provider Tools
• payer Solutions
• policy Management
• prior Authorization
• Administrative
• Interoperability
• Automation
• Compliance
• Payer Tools

Summary

PA Checkpoint is a cloud-based SaaS solution by Itiliti Health that enables providers to determine the need for prior authorization in real time, reducing administrative burdens and costs.

Description

PA Checkpoint is a cloud-based SaaS product developed by Itiliti Health to help healthcare providers quickly ascertain whether a prior authorization is required for a procedure. By offering a searchable medical policy database organized by CPT code, it allows providers to make real-time determinations without contacting payers, thereby reducing call volumes and unnecessary prior authorization submissions. This leads to significant administrative cost savings and improved operational efficiency for healthcare organizations.

Api Available

yes

Certifications

• SOC 2
• HITRUST

Company Founding

2019

Company Offices

• United States

Compliance

• HIPAA
• SOC 2
• HITRUST

Customers

• Major Blues Plan
• Large Regional Health Plan
• Health Plan

Data Residency

United States

Data Standards

• FHIR Prior Authorization (PARDD / CRD)
• PARDD Documents/Templates/Requirements (DTR)
• EDI (standard EDI/claim/transaction interfaces)

Deployment Model

• SaaS

Features

• Real-time prior authorization determination
• Searchable medical policy database organized by CPT code
• Policy management (create, import, redline, comment, versioning)
• PARDD/CRD and DTR interfaces for policy discovery and document exchange
• APIs for coverage requirement discovery and workflow integration
• PA routing rules to direct submissions to correct department/LOB
• Automatic authorization rules (auto-approve when structured criteria met)
• Clinical Decision Assistant with AI/ML search and evidence tagging
• Audit trail and comprehensive reporting
• Provider portal and payer website integration
• Mass upload/import of policy requirements (spreadsheet/API)
• Configurable role-based user management and access restrictions
• Phased implementation capability (under 60 days typical)

Id

SW1592

Integration Partners

• VirtualHealth
• ZS
• Epic
• Onyx

Integrations

• VirtualHealth
• ZS
• Epic
• VirtualHealth HELIOS

Languages Supported

• English

Last Updated

2025-10-11

License

commercial

Market Segment

• enterprise
• smb

Optional Modules

• Policy Management
• PA Routing
• Automatic Authorization Rules
• Clinical Decision Assistant
• PA Complete / end-to-end PA automation (integrations with partners)

Os Platforms

• Web

Pricing Details

Contact vendor for pricing information.

Pricing Model

subscription

Privacy Features

• Payer-controlled policies and data (payer retains control of policy data)
• Privacy practices and security measures described in company Privacy Policy

Product Code

SW1592

Product Name

PA Checkpoint

Ratings

• PA Checkpoint has significantly reduced our prior authorization processing times, leading to improved efficiency.
• The integration with our existing systems was seamless, and the user interface is intuitive.
• Since implementing PA Checkpoint, we've seen a noticeable decrease in provider call volume and call duration.
• The real-time determination feature has streamlined our workflow and reduced administrative burden.
• PA Checkpoint's robust reporting capabilities have enhanced our compliance tracking and reporting processes.

Regions Available

• United States

Related Urls

• https://www.linkedin.com/company/itiliti-health
• https://www.dnb.com/business-directory/company-profiles.itiliti_health.00b94328ea70f6b4c8c3c370263b98d8.html
• https://www.gaebler.com/Funded-Company-D1D36127-3B15-4678-BBFF-7DCD1A6ADDD0-Itiliti-Health
• https://elion.health/products/itiliti-health

Release Year

2019

Security Features

• Role-based access control (user management with roles)
• Access restrictions and logging / audit trails
• Secure API interfaces
• Encryption in transit and at rest

Specialties

• General Medicine
• Surgery
• Cardiology
• Orthopedics
• Neurology
• Oncology
• Pediatrics
• Obstetrics
• Gynecology
• Dermatology
• Gastroenterology
• Pulmonology
• Rheumatology
• Urology
• Endocrinology
• Psychiatry
• Emergency Medicine
• Anesthesiology
• Radiology
• Pathology

Support Channels

• email
• phone
• chat
• ticketing
• community
• 24x7

System Requirements

Cloud-hosted (AWS referenced); integrates via APIs/EDI with existing payer/provider systems; no heavy on-prem requirements for typical deployments

Target Users

• clinicians
• nurses
• admins
• payers

Training Options

• documentation
• webinars
• live_online
• onsite
• certification

Type

product

User Reviews

• PA Checkpoint has significantly reduced our prior authorization processing times, leading to improved efficiency.
• The integration with our existing systems was seamless, and the user interface is intuitive.
• Since implementing PA Checkpoint, we've seen a noticeable decrease in provider call volume and call duration.
• The real-time determination feature has streamlined our workflow and reduced administrative burden.
• PA Checkpoint's robust reporting capabilities have enhanced our compliance tracking and reporting processes.

Version

1.0

Alternatives

See related products

Canonical JSON

{
  "product_name": "PA Checkpoint",
  "company_name": "Itiliti Health",
  "product_url": "https://itilitihealth.com/products/pa-checkpoint",
  "company_url": "https://itilitihealth.com",
  "related_urls": [
    "https://www.linkedin.com/company/itiliti-health",
    "https://www.dnb.com/business-directory/company-profiles.itiliti_health.00b94328ea70f6b4c8c3c370263b98d8.html",
    "https://www.gaebler.com/Funded-Company-D1D36127-3B15-4678-BBFF-7DCD1A6ADDD0-Itiliti-Health",
    "https://elion.health/products/itiliti-health"
  ],
  "product_code": "SW1592",
  "summary": "PA Checkpoint is a cloud-based SaaS solution by Itiliti Health that enables providers to determine the need for prior authorization in real time, reducing administrative burdens and costs.",
  "description": "PA Checkpoint is a cloud-based SaaS product developed by Itiliti Health to help healthcare providers quickly ascertain whether a prior authorization is required for a procedure. By offering a searchable medical policy database organized by CPT code, it allows providers to make real-time determinations without contacting payers, thereby reducing call volumes and unnecessary prior authorization submissions. This leads to significant administrative cost savings and improved operational efficiency for healthcare organizations.",
  "categories": [
    "administrative Operations",
    "clinical Decision Support",
    "data Integration",
    "compliance Management",
    "healthcare It",
    "provider Tools",
    "payer Solutions",
    "policy Management",
    "prior Authorization",
    "Administrative",
    "Clinical Decision Support",
    "Interoperability",
    "Automation",
    "Compliance",
    "Healthcare It",
    "Provider Tools",
    "Payer Tools",
    "Policy Management",
    "Prior Authorization"
  ],
  "market_segment": [
    "enterprise",
    "smb"
  ],
  "target_users": [
    "clinicians",
    "nurses",
    "admins",
    "payers"
  ],
  "specialties": [
    "General Medicine",
    "Surgery",
    "Cardiology",
    "Orthopedics",
    "Neurology",
    "Oncology",
    "Pediatrics",
    "Obstetrics",
    "Gynecology",
    "Dermatology",
    "Gastroenterology",
    "Pulmonology",
    "Rheumatology",
    "Urology",
    "Endocrinology",
    "Psychiatry",
    "Emergency Medicine",
    "Anesthesiology",
    "Radiology",
    "Pathology"
  ],
  "regions_available": [
    "United States"
  ],
  "languages_supported": [
    "English"
  ],
  "pricing_model": "subscription",
  "pricing_details": "Contact vendor for pricing information.",
  "license": "commercial",
  "company_offices": [
    "United States"
  ],
  "company_founding": "2019",
  "deployment_model": [
    "SaaS"
  ],
  "os_platforms": [
    "Web"
  ],
  "features": [
    "Real-time prior authorization determination",
    "Searchable medical policy database organized by CPT code",
    "Policy management (create, import, redline, comment, versioning)",
    "PARDD/CRD and DTR interfaces for policy discovery and document exchange",
    "APIs for coverage requirement discovery and workflow integration",
    "PA routing rules to direct submissions to correct department/LOB",
    "Automatic authorization rules (auto-approve when structured criteria met)",
    "Clinical Decision Assistant with AI/ML search and evidence tagging",
    "Audit trail and comprehensive reporting",
    "Provider portal and payer website integration",
    "Mass upload/import of policy requirements (spreadsheet/API)",
    "Configurable role-based user management and access restrictions",
    "Phased implementation capability (under 60 days typical)"
  ],
  "optional_modules": [
    "Policy Management",
    "PA Routing",
    "Automatic Authorization Rules",
    "Clinical Decision Assistant",
    "PA Complete / end-to-end PA automation (integrations with partners)"
  ],
  "integrations": [
    "VirtualHealth",
    "ZS",
    "Epic",
    "VirtualHealth HELIOS"
  ],
  "data_standards": [
    "FHIR Prior Authorization (PARDD / CRD)",
    "PARDD Documents/Templates/Requirements (DTR)",
    "EDI (standard EDI/claim/transaction interfaces)"
  ],
  "api_available": "yes",
  "system_requirements": "Cloud-hosted (AWS referenced); integrates via APIs/EDI with existing payer/provider systems; no heavy on-prem requirements for typical deployments",
  "compliance": [
    "HIPAA",
    "SOC 2",
    "HITRUST"
  ],
  "certifications": [
    "SOC 2",
    "HITRUST"
  ],
  "security_features": [
    "Role-based access control (user management with roles)",
    "Access restrictions and logging / audit trails",
    "Secure API interfaces",
    "Encryption in transit and at rest"
  ],
  "privacy_features": [
    "Payer-controlled policies and data (payer retains control of policy data)",
    "Privacy practices and security measures described in company Privacy Policy"
  ],
  "data_residency": "United States",
  "customers": [
    "Major Blues Plan",
    "Large Regional Health Plan",
    "Health Plan"
  ],
  "user_reviews": [
    "PA Checkpoint has significantly reduced our prior authorization processing times, leading to improved efficiency.",
    "The integration with our existing systems was seamless, and the user interface is intuitive.",
    "Since implementing PA Checkpoint, we've seen a noticeable decrease in provider call volume and call duration.",
    "The real-time determination feature has streamlined our workflow and reduced administrative burden.",
    "PA Checkpoint's robust reporting capabilities have enhanced our compliance tracking and reporting processes."
  ],
  "ratings": [
    "PA Checkpoint has significantly reduced our prior authorization processing times, leading to improved efficiency.",
    "The integration with our existing systems was seamless, and the user interface is intuitive.",
    "Since implementing PA Checkpoint, we've seen a noticeable decrease in provider call volume and call duration.",
    "The real-time determination feature has streamlined our workflow and reduced administrative burden.",
    "PA Checkpoint's robust reporting capabilities have enhanced our compliance tracking and reporting processes."
  ],
  "support_channels": [
    "email",
    "phone",
    "chat",
    "ticketing",
    "community",
    "24x7"
  ],
  "training_options": [
    "documentation",
    "webinars",
    "live_online",
    "onsite",
    "certification"
  ],
  "release_year": "2019",
  "integration_partners": [
    "VirtualHealth",
    "ZS",
    "Epic",
    "Onyx"
  ],
  "id": "SW1592",
  "slug": "pa-checkpoint",
  "type": "product",
  "version": "1.0",
  "last_updated": "2025-10-11",
  "links_json": {
    "self": "https://www.healthaidb.com/software/pa-checkpoint.json"
  }
}