Workflow
AI may assist with extraction and drafting. It never approves, denies, or attests.
New Rx signals enter through the integration layer (mock adapters in the demo environment).
Coverage checks surface when prior authorization is required before dispense.
Medication continuity detects escalation (e.g. 7.5 mg → 10 mg) and gathers lower-dose history.
A single authoritative PA case is created — duplicate requests attach to the same record.
Required clinical and continuity evidence is versioned with provenance.
The case is blocked with an explicit waiting-on party and required action — not a vague “pending.”
Providers attest continuity; submission uses simulated payer responses in the demo (not a live network call).
Simulated payer decision, pharmacy adjudication, and dispense close on the same chain of custody.