Audited Operational & ROI Benchmarks
System Architecture Blueprint
EHR & Clinical Note Parsing
- HL7 FHIR API integration reading progress notes and physician orders
- Air-gapped clinical NLP extracting diagnoses, lab values, and medication history
- Automated de-identification and zero data retention outside hospital perimeter
Deterministic Medical Necessity Matcher
- LangGraph agentic graph comparing clinical evidence to CMS and payer guidelines
- Automated ICD-10 and CPT coding verification with clinical rule gates
- Confidence scoring flagging edge cases for senior physician sign-off
Payer EDI Dispatch & Real-Time Polling
- Automated packaging and transmission of ANSI X12 278 authorization requests
- Continuous automated polling of payer clearinghouses for approval status
- Real-time EHR writeback updating scheduled procedure status
Key Moments & Timestamps
Full Verbatim Technical Transcript
Experience prior authorization automation software for healthcare CTOs that clears claims in minutes. Clinical staff burn 20 hours a week on telephone hold with insurance payers while delayed approvals postpone urgent surgical procedures. Elesium's air-gapped HIPAA and DPDP compliant agents parse clinical notes, cross-reference ICD-10 medical necessity codes, and format payer submission packets autonomously. Slashes approval turnaround from 7 days to 42 minutes, cuts administrative denial appeals by 81%, and recovers ₹26 Lakhs in billing leakage. Automate clinical prior authorization securely at elesium.online.
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Elesium engineers deterministic agentic state machines inside private VPCs, delivering audited 3x–5x cash-flow ROI in 90 days with guaranteed SLAs.