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Gistia Payer Solution Catalog

Complete the order. Prepare the case. Connect the review.

Start with missing orders and documentation, prior authorization, or clinical review. Configure the workflow around your lab benefit requirements, responsible teams, and existing systems.

See the solutions Discuss payer workflows
  1. 01ReceiveOrder and requisition
  2. 02CompleteRecords and context
  3. 03PrepareBenefit requirements
  4. 04RouteAuthorization and evidence
  5. 05ReviewAuthorized judgment
  6. 06Follow throughStatus and claim context

Solution Catalog

Start with missing orders, authorization, or review.

Three focused solutions connect order completion, approved benefit requirements, and authorized review. Each has its own scope, owners, and completion criteria.

Missing orders and documentation

Order Completion

Bring incomplete orders, clinical records, provider follow-up, and missing items into one queue. Track corrections through the agreed, confirmed handoff.

RequisitionsClinical recordsProvider requestsOwnershipHandoff
Start here when

Teams repeatedly chase missing requisitions, clinical records, or provider information and lose track of the next action.

Discuss missing-order workflows

Order completion workflow

  1. 01
    IdentifyFind missing order information and records
  2. 02
    RequestAssign a specific provider or lab follow-up
  3. 03
    CompleteBring corrections and evidence into the case
  4. 04
    ReviewRoute unresolved items to the responsible team
  5. 05
    ConfirmRecord the agreed, authorized handoff
Designed around your operationA completed order, an authorization response, and a claim outcome remain separate records in the workflow.

Benefit requirements and review

Prepare the authorization case and support the reviewer.

Bring approved requirements, evidence, exceptions, and returned decisions into the same operating path.

Prior Authorization

Benefit requirements and authorization

Prepare the case against approved benefit and documentation requirements, route exceptions for authorized review, and track submission and returned status.

Start here when

Teams repeatedly assemble the same requirements, chase missing evidence, or manually route exceptions.

Discuss prior authorization

Payer Review Portal

Authorized clinical review

Give payer reviewers the order, supporting evidence, criteria version, open issues, and decision record, with status returned to the responsible teams.

Start here when

Reviewers must reconstruct the order, policy requirements, supporting evidence, or decision history across systems.

Discuss clinical review support

Each solution is scoped around approved benefit requirements, client-owned decisions, existing systems, and agreed operating measures.

Lab benefits management

Connect benefit requirements across all three.

Use approved plan and formulary criteria, network rules, documentation needs, and decision rights to configure each workflow. Connect the order and available authorization and claim records through agreed interfaces.

Discuss integration

Which payer workflow should improve first?

Start with the missing-order backlog, authorization workload, clinical review, provider follow-up, or order-to-claim gap.

Discuss the workflow Explore Custom AI Solutions