Olive AI \USA

PriorFlow is a vertical AI solution that automates prior authorization for a single specialty: oncology infusion centers. Instead of trying to automate all of healthcare, we focus on the highest-pain, highest-value workflow in cancer care. Oncology prior auths are uniquely terrible - they require clinical documentation, treatment protocols, biomarker results, and payer-specific medical policies. A single prior auth can take 4-8 hours of nurse time and delay treatment by days or weeks. Our AI agent ingests the patient's EHR data (via FHIR API or HL7 feed), reads the oncologist's treatment plan, pulls relevant clinical guidelines (NCCN, ASCO), and generates a complete prior auth submission with supporting documentation. It knows each payer's specific requirements and formats the submission accordingly. When payers request additional information, the AI responds automatically. The key insight: oncology practices will pay $500-1000 per approved prior auth because the alternative is hiring more nurses or delaying chemotherapy. We charge per successful authorization, not per seat or transaction. Our unit economics work because we use LLMs (GPT-4 + fine-tuned medical models) to handle the complexity without custom engineering for each client. We start with a single EHR (Epic, which has 50%+ market share in oncology) and a single payer (UnitedHealthcare, the largest). Once we prove ROI in this narrow wedge, we expand to other payers, then other EHRs, then adjacent specialties (cardiology, rheumatology). The business model is sustainable because oncology practices have high revenue per patient ($100K+ per treatment course) and prior auth is a clear bottleneck to revenue. We're not selling cost savings - we're selling faster time-to-treatment and higher approval rates.