Introduction

Overview

AccelRx.ai is an AI-powered prior authorization platform for specialty clinics. It replaces the manual grind of researching payer policies, filling PA forms, submitting faxes, tracking decisions, and writing appeals.

This documentation covers everything from your first case to advanced workflows like the appeal reframing engine and the AI form-fill agent. If you get stuck at any point, reach out — we answer within one business day.

What is AccelRx?

Think of AccelRx as the operating system for your PA team. It's three things rolled into one:

1. An intake system for doctors — a private link where they upload chart notes.
2. An AI analyst that researches policies and fills forms.
3. A case management workspace for staff to review, submit, monitor, and appeal.

The goal is zero context switching. Staff don't jump between fax portals, payer websites, submission portals, and the EHR. Everything lives in one case page.

How is this different from a submission platform? Conventional submission tools just route the PA from your office to the payer. AccelRx fills the form for you, researches the policy, drafts the LMN, and writes the appeal — submission is the last step, not the only step.

Quickstart

Here's the shortest path to getting your first approval:

1. Log in at app.accelrx.ai with the credentials your admin created for you.
2. Click New Case — or have your doctor upload a chart note via the intake link.
3. Attach the existing PA request ID, if you have one. The PA form, patient details, and prescriber info populate automatically.
4. Review the AI Analysis panel — the coverage criteria status and any documentation gaps.
5. Click Generate LMN. Edit in place if needed.
6. Click Fill PA Form. Watch the browser work in real time.
7. Submit electronically or send the fax packet.

The whole flow takes about 3–5 minutes of hands-on time per case instead of 45.

Your first case, step by step

Creating a case

There are three ways cases get created in AccelRx:

• Doctor intake upload — a doctor visits /intake, enters patient info, and drops a chart note PDF. A shell case is created automatically. Staff then attaches the PA request later.
• PA request import — staff pastes an existing PA request ID from the payer's portal. We download the PA form and parse it into a full case.
• Manual entry — staff clicks "New Case" and fills in the details by hand. Rare, but supported.

Uploading chart notes

After a case exists, upload the chart note PDF. Our AI engine extracts the clinical profile:

• Diagnosis codes and labs (A1c, BMI, LDL, blood pressure, eGFR, etc.)
• Medication history with dates and outcomes
• Relevant comorbidities
• Contraindications and allergies

This structured data is what we use to score coverage, fill the PA form, and draft the LMN.

Reviewing the AI analysis

Once analysis runs, you'll see a coverage score (0–100) and a criterion-by-criterion breakdown. Every criterion has one of three statuses: met, partial, or gap. Every status has an evidence quote pulled directly from the chart note — never invented.

If the AI says a criterion is met, you can trust the citation. If it says "partial" or "gap", read the suggested strategy — it'll tell you exactly what's missing and how to fix it.

Core concept: the Case

Everything in AccelRx is organized around cases. A case is a single prior authorization attempt for one patient × one drug × one payer. It holds:

• Patient, prescriber, insurance, and medication data
• Chart notes and attachments
• The parsed payer policy and coverage analysis
• PA form questions and answers
• LMN, appeal letter, redetermination form, fax packets
• Audit log and comments

Every case has a status that drives the workflow: pending_notes → analyzing → form_ready → submitted → approved (or → denied → appealing → approved).

The workflow

The canonical flow looks like this:

Chart note upload  →  AI analysis      (30 seconds)
                   →  Policy research  (auto)
                   →  LMN draft        (10 seconds, one click)
                   →  PA form fill     (2–3 minutes, automated)
                   →  Submit / fax     (one click)
                   →  Monitor status   (automatic polling)
                   →  Approval  OR
                   →  Denial  →  Reframe chart note
                              →  Draft appeal letter
                              →  Fax appeal packet
                              →  Approval

Roles and permissions

AccelRx has three roles — each with different capabilities:

• Admin — full access. Creates users, manages catalogs, sees billing.
• Staff — does PA work. Can create cases, submit, appeal, manage everything except users and billing.
• Doctor — monitor-only by default. Uploads notes, views their own cases, leaves comments. Admins can grant write permissions on a per-user basis.

For doctors, the default permission set is deliberately minimal. You want your clinicians focused on patients, not PA forms. Staff handles everything else.

Payer policies

Every PA is evaluated against a payer policy — the list of coverage criteria the payer uses to approve or deny. AccelRx maintains a library of parsed policies for major payers and the top specialty drugs. When a case uses a payer × drug combo we haven't seen, our research agent goes and finds the current policy with citations.

You can always override the auto-matched policy if you think we chose the wrong one — just click Re-find policy on the case detail page.

Chart note intake

The intake flow at /intake is designed for one thing: making it stupid-simple for a doctor to send you a chart note.

• No login required (tokenized link per doctor)
• Just patient name, DOB, and a PDF
• We extract the patient info from the PDF; the form fields are a fallback
• If the patient already has an open case, we attach the new note to it automatically

AI analysis

Our analysis engine runs a three-pass process:

1. Extraction — structured clinical profile from the chart note (labs, meds, conditions).
2. Criterion scoring — every payer-policy criterion scored against the profile with evidence citations.
3. Strategy — for any criterion that's partial or a gap, a concrete action you can take (e.g., "Request updated A1c within 90 days" or "Document metformin trial date").

PA form fill

The form-fill agent uses smart browser automation to log into the payer's submission portal with your credentials, navigate to the PA form, and answer every question using the clinical profile. You can watch it work in real time on the case page. Anything it can't answer gets surfaced in a "Manual Review" banner.

Appeals workflow

When a case gets denied, drop the denial letter (PDF or image) into the Denial section. We'll:

• Parse the denial reasons and cite the specific criteria that failed
• Reframe the chart note to address each denial point
• Draft the appeal letter in the prescriber's voice
• Pre-fill the redetermination form if one exists
• Build a single fax packet: cover + appeal letter + redetermination + chart notes + denial + attachments

Fax delivery

Faxes go out through our HIPAA-compliant fax delivery integration — BAA-backed. You get back a delivery receipt with the fax message ID, which gets tracked on the case page with auto-refresh on status.

HIPAA compliance

AccelRx is built for PHI from day one:

• PHI encrypted at rest using rotating Fernet keys
• Encrypted in transit (TLS 1.3)
• BAA provided on request
• Session timeouts after 30 minutes of inactivity
• PHI never used to train AI models — we use your data only to serve your requests

Audit trail

Every state change, file upload, PDF generation, form submission, and fax send is logged with user attribution, IP address, and timestamp. The audit log is visible per-case and exportable practice-wide for HIPAA reviews.