ACTIONS

Modular AI for any clinical workflow

Deploy AI with 90%+ performance out of the box on even the most complex clinical tasks.

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ENTERPRISE-GRADE AI

AI that gets past the last mile

90%+

performance benchmarks on day one

56%

reduced staff burden time

99.24%

end-to-end clinical accuracy, KLAS-verified

ACTIONS

Precision AI for healthcare

Most AI tools in healthcare are generic point solutions and unsafe for specialized work. Anterior’s Actions are precise, modular, and purpose-built with the safety, compliance, and observability that healthcare demands.

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Compliance and observability

Built to rigorous healthcare standards with pre-defined failure mode ontologies

FHIR-native and API-first

Designed for seamless integration

Composable intelligence

Combine Actions with your own agents and workflows for performance and scale

Gather

Collect the right information and bring it into context

Utilization management

Intake clinical documentation for prior auth requests.

Claims adjudication

Retrieve missing provider information to reduce rework.

Quality and risk adjustment

Aggregate encounter and demographic data for reporting season.

Verify

Check accuracy and completeness and ensure validity for use

Member services

Confirm member eligibility and benefits for call center encounters.

Compliance

Validate document recency and completeness for audits.

Claims adjudication

Cross-check plan rules and exclusions for payment terms accuracy.

Prepare

Organize messy inputs into structured outputs with logical decision trees

Regulatory readiness

Convert medical policies into FHIR-compliant logic.

Medical management

Parse and classify clinical notes for review workflows.

Provider data

Extract structured data from faxes for database management.

Reason

Interpret information and apply clinical logic to reach the right outcome

Utilization management

Match against policies and determine medical necessity.

Fraud, waste, and abuse

Identify coding patterns to predict and prevent FWA.

Risk adjustment

Match member RAF scores with claims documentation for gap closure.

Summarize

Condense details into clear, useful and templated outputs for quick understanding

Utilization management

Auto-generate denial letters and communications to providers and members.

Compliance

Provide structured, audit-ready case summaries for regulatory oversight.

Network management

Create real-time provider feedback notes for Network Management and care coordination.

Connect

Link real-time information across teams to reveal patterns and enable next steps

Care management

Link siloed member records across systems for preventative health and intervention programs.

Population health

Integrate claims, clinical, and pharmacy data for holistic insights.

HEDIS/Stars

Connect quality measures with member outcomes for performance tracking and reporting.

FIT FOR PLANS

Build any way you want

Managed deployments

Our team of forward-deployed clinicians and AI engineers can get you to ROI quickly.

Integrate it yourself

Or, take our pre-built actions and deploy yourself. All with the security of the Anterior platform.

BUILT FOR PAYER SYSTEMS

Healthcare isn’t a place for risky trials

Anterior is a FHIR-native, API-first platform that integrates seamlessly with existing payer systems like HealthEdge and MCG, making it easy to scale without disrupting workflows.

Healthcare-grade security

With built-in compliance and rigorous evaluation.

Transparency and trust

Anterior runs transparently in immutable audit and AI reasoning logs.

Human-in-the-loop collaboration

Clinicians guide, review, and refine AI reasoning to ensure medical accuracy.

Case Study

Anterior transformed prior authorizations for a large payer enterprise.

prior authorizations a year

99.24%

clinical accuracy (KLAS-verified)

clinician CSAT score

Need more proof to build a business case?

Test our solution and get concrete ROI within weeks. We only need a maximum of 10 hours of your time.

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