AI Medical Necessity Review
Is this procedure justified?
Upload a medical record and a medical order. Our AI drafts a medical-necessity review, highlights the evidence, and helps your team decide what is ready for prior authorization.
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Reviewed by: Arkangel AI clinical review team, Medical necessity and prior authorization content
What is AI medical necessity review?
AI medical necessity review compares the clinical record, requested procedure, symptoms, prior workup, and documented evidence to determine whether a service is justified. Arkangel AI helps teams prepare prior authorization decisions by surfacing missing documentation, explaining clinical reasoning, and keeping reviewers focused on exceptions that need human judgment.
AI prior authorization review vs. manual review
How automated medical necessity review supports teams that need faster, consistent pre-authorization decisions.
| Need | Arkangel AI | Manual review |
|---|---|---|
| Case coverage | Screens submitted records and orders before authorization work begins | Often prioritizes only the most urgent or complex cases |
| Evidence review | Summarizes symptoms, diagnosis, workup, and justification together | Requires reviewers to assemble evidence from long records |
| Turnaround | Produces a structured necessity readout in minutes | Can take hours when queues and records are long |
| Audit trail | Keeps the clinical rationale visible for reviewer validation | Depends on notes entered after the review |
Trusted by 100,000+ medical professionalsfrom these care centers
Prior authorization intelligence that scales
Stop reviewing manually. Our AI reads the medical record and medical orders, surfaces supporting evidence, and helps your team prepare prior authorization reviews so reviewers can focus on exceptions, not routine document checks.
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See what others miss
Our AI reads every chart cover-to-cover, surfacing billable details, documentation gaps, and revenue opportunities that manual reviews routinely overlook.
Evidence at your fingertips
Get instant access to clinical guidelines and the latest literature. Every recommendation backed by real evidence, delivered in seconds.
Your safety net for every patient
Flag clinical risks, catch documentation errors, and surface at-risk patients before they become denials—all in real time across your entire census.
Recover revenue you didn't know you lost
Identify missed charges, undercoded visits, and hidden opportunities buried in your records. Turn overlooked care into earned revenue.
ISO 27001 Certified. HIPAA Compliant.
70+ security controls, penetration tested, and continuously monitored via Vanta.
Compliance Center
ISO 27001:2022 certified, HIPAA compliant, and penetration tested. With 70+ security controls covering infrastructure, data privacy, and audit procedures—plus continuous monitoring via Vanta—your PHI stays protected with enterprise-grade cryptographic controls and information access restrictions.
Explore the Compliance CenterBuilt for Healthcare Teams
Role-based access control, secure development policies, and system change procedures let your team collaborate safely. Scale across departments with audit trails, asset handling controls, and subprocessors like Azure for anonymization—all documented in our public Compliance Center.
Book a demoPlans and Pricing
Every plan includes complete chart review capabilities. Start free and scale from solo practitioners to enterprise health systems.
Pro
For individual practitioners
- 2-3x higher messaging limits
- 3x more medical evidence
- Voice-based medical consultations
TeamMost popular
For clinics scaling chart review
- Team collaboration tools
- Centralized billing
- Shared libraries
- Automatic anonymization
- Priority access to features
- Dashboard with usage statistics
Enterprise
For health systems at scale
- ISO 27001 compliance
- SSO & advanced security
- Support & training
- Assigned Success Manager
Join 100,000+ medical professionals using AI in healthcare
Loved by world-class medical professionals all around the world.
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