Requests reach review incomplete.
Organize the request, clinical context, required records, checks, issues, and follow-up before review begins.
For payer leaders
Move diagnostic requests through review with less delay and rework.
Gistia helps payer leaders improve how diagnostic requests, evidence, criteria, exceptions, and decisions move across the organization. We set the operating model, build the systems, and support them in production.
Trusted by & Technology Partners
AccuMed Laboratories
Custom AI Solutions
Build a new operating capability around a review priority.
Connect policy, evidence, workflow, and systems when the priority crosses functions.
Best when
Explore Custom AI for Payers →Solution CatalogThe change spans intake, criteria, review, follow-through, or multiple systems.
Improve one defined diagnostic review workflow.
Start with a focused solution for order completion, prior authorization, or payer review.
Best when
Explore Payer Solutions →The immediate need has a clear owner, workflow, and measurable outcome.
Where to focus
Start where diagnostic review is losing time.
Choose the operating problem creating rework, delay, or weak follow-through. The right delivery path depends on how broad the change needs to be.
Evidence and criteria are assembled manually.
Bring approved criteria and case evidence together so reviewers can see what is supported and what is missing.
Teams lose visibility after a decision.
Return review status to the right systems and track next actions, exceptions, timing, effort, control, and cost impact.
Payer and healthcare outcomes
See how teams reduced rework and improved operating control.
Examples across claims processing, rule coordination, and financial-assistance operations.
Claims operations
Reducing claim denials through better processing and intelligence.
Claims processing and denial insight were connected to reduce rework and improve payment flow.Read the case study →
Network rule operations
Connecting network rules and contract coordination.
A pathology network connected rule management, assignments, and contract execution.Read the case study →
Financial-assistance operations
Financial assistance moved from paper intake to a connected path.
Applications, document data, and billing were connected to support faster access decisions.Read the case study →Which review workflow should improve first?
Start with the order, evidence, authorization, or follow-through workflow creating the most delay or manual effort.