Why Authora exists.

That statistic — 80.7%— is the founding fact of this company. Read it once and the implications stack up fast. If a payer’s denials are overturned eight times out of ten on appeal, the denials were wrong at issuance. The appeals process is not a check on edge cases; it is the actual adjudication process, run in slow motion, with a patient’s care delayed for the duration. The first decision is not a decision. It is an obstacle whose only job is to filter out the patients who give up.

And most do. Fewer than 12% of denied Medicare Advantage prior authorizations are ever appealed. Multiply that by the overturn rate and the conclusion is uncomfortable: every year, a knowable number of Americans do not get care that, on the evidence, they were entitled to under their own coverage. They did not get it because the friction worked.

We started Authora because that gap is closeable, and because the regulatory window that just opened — CMS-0057-F — means closing it became a contractual obligation by January 1. Payers will have to publish their PA turnaround times, denial rates, and approval-rate-by-procedure category every year. The friction was profitable when it was invisible. It will be considerably less so when the numbers are on a public site indexed by every benefits consultant in the country.

We are not building an AI denial-faster machine. We are building the platform that produces the published numbers, truthfully, and produces them well — because the system underneath is set up to answer the right question at the right moment, with the evidence already attached.