Build the healthcare AI business case — payer turnaround and patient access in the same model.
Utilization management, patient access, member and patient service. Model auto-approval rates, reviewer productivity, administrative call containment and no-show recovery with numbers your CFO and compliance leaders can defend.
Model the number your board already tracks.
Every calculator is ungated, gives conservative, base and aggressive scenarios, and exports an enterprise-styled PDF with your inputs.
Auto-approval against criteria, reviewer productivity, avoidable appeals and provider status calls — CMS turnaround aware.
Open calculator →Administrative call containment plus no-show recovery valued at contribution margin, not gross charges.
Open calculator →Voice AI, agent assist and automated QA across member services, benefits and billing inquiries.
Open calculator →Denials prevented at submission, appeal win-rate lift, rework capacity returned and cash pulled forward — valued at net reimbursement.
Open calculator →Claims correspondence, eligibility checks, referrals and records requests — hours and dollars returned.
Open calculator →The operating metrics that decide funding in this sector.
Auto-approval share and reviewer throughput against CMS and state turnaround requirements.
Scheduling, status, benefits and billing calls containable without clinical judgement.
Recovered appointments and referrals valued at contribution margin per visit.
Minutes returned per case, and where a human review gate stays mandatory.
Avoidable appeals and rework created by inconsistent first-pass decisions.
Automated QA across 100% of interactions instead of a 2% manual sample.
Pressure-test your healthcare AI business case with a clinical-operations-aware team.
Bring your prior authorization volumes, patient access call mix or member service staffing. In 30 minutes we validate the inputs, flag the assumptions that will not survive finance review, and outline a 90-day path to a defensible pilot.
Before you build the business case.
Do these models work for both payers and providers?
Yes. The prior authorization model is built for health plans and utilization management teams; the patient access model is built for health systems and physician groups. Contact center and automation models apply to both.
How do you value no-show recovery?
At contribution margin per recovered visit, not gross charges — so the number survives a finance review.
Is anything in these calculators PHI-sensitive?
No. Every calculator runs entirely in your browser on aggregate operating inputs. Nothing is submitted, stored or emailed unless you choose to book a session.
Can you validate our inputs against benchmarks?
Yes — a 30-minute working session reviews your volumes, turnaround times and staffing assumptions against comparable payer and provider programs.