Meridian
Prior Authorization Shouldn't Take This Long
Problem
- Prior Authorization Is A Painful Bottleneck in Med Tech
- PAs consume over 15 hours a week of physician and staff time
- 40% of practices now employ staff dedicated exclusively to PA administration
- 81.7% of appealed denials are overturned — meaning most initial denials are preventable documentation errors
- 93% of physicians say PA delays patient access to necessary care
Lack of guidance is the root cause.
Clinicians assemble documentation without clear visibility into payer-specific requirements. Incomplete submissions trigger pend cycles — phone calls, faxes, and resubmissions that multiply the time and cost of every case.
Meridian fixes this at the source.
Step 1
Clinical Document Ingestion
Upload patient clinical records. Meridian's AI extracts relevant data — demographics, insurance information, diagnoses, treatment history — automatically.
Insurance Eligibility Verification
Step 2
Real-time 270/271 eligibility checks via Stedi verify coverage, calculate patient responsibility, confirm network status, and handle primary/secondary insurance — before anyone picks up the phone.
AI-Powered Gap Analysis
Step 3
Meridian compares the patient's clinical profile against payer-specific coverage requirements (Medicare LCDs, commercial payer policies) and flags documentation gaps before submission.
Step 4
Pre-Submission Scoring
Our hybrid scoring engine applies deterministic rules for hard clinical criteria and AI reasoning for nuanced clinical judgment — giving you a predicted approval likelihood and specific guidance on what's missing.
Step 5
Letter of Medical Necessity Generation
Auto-generated LOMNs cited directly from patient evidence. Not boilerplate — evidence-backed documentation tailored to the specific payer and device.
Step 6
Submission & Tracking
Electronic submission via FHIR APIs (PAS). Real-time status tracking. No more phone calls to check progress.
Intelligent Prior Authorization, End to End
Meridian moves through a structured, six-step workflow that automates every stage — with humans staying in the loop to review and attest before submission.
DaVinci Compliance
Built for CMS Mandates, Ready for What's Next
CMS-0057-F requires payers to implement Da Vinci FHIR-based prior authorization APIs by January 2027. Meridian is built on those standards — partnered with Smile Digital Health, a leading FHIR infrastructure provider already deployed with Blue Cross Blue Shield of NC, Cigna, UPMC, Highmark, and Kaiser Permanente.
The three Da Vinci Implementation Guides Meridian supports:
CRD (Coverage Requirements Discovery)
DTR (Documentation Templates & Rules)
Real-time query at point of ordering: Is PA required? What documentation is needed? Know requirements before scheduling, not after.
Payer-specific questionnaires auto-populated from EHR data. The system tells you exactly what's needed, in the format the payer wants.
PAS (Prior Authorization Support)
Electronic PA submission and response via FHIR APIs. No more fax. No more phone. Submit and track electronically.
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Built to scale and last.
Technical Highlights
HIPAA-compliant architecture
eFax integration via UBIX
Three-tier RBAC system
Built to handle ~5,000 PA cases per month at scale
EHR integration roadmap (MedPlum, OpenEMR)
Before & After
TODAY
WITH MERIDIAN
PA requirements
Unknown until submission
Unknown until submission
Time per device PA
25 minutes
10–12 minutes
Status visibility
30–40%
<10%
Pend/rework rate
Phone/fax
Real-time portal
Denial feedback
Generic notices
Specific, actionable guidance
Code accuracy
Manual entry, error-prone
Semantic standardization validates codes
See Meridian in Action
Whether you're managing hundreds of prior authorizations a month or thousands, Meridian was built to handle it — and built to be customized to your payer mix, device categories, and clinical workflows.
Contact us to learn more.
20937 Ashburn Road
Ashburn, VA 20147
Address
info@2q.com