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Payer Integrations

Prior Auth. Eligibility. Claims. Automated.

Vorro's FHIR-native payer integration platform automates prior authorization, eligibility verification, claims, and payer-provider data exchange — reducing admin burden by up to 70%.

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Live Integration Flow
Health Plans
Clearinghouses
CMS APIs
FHIR Endpoints
Vorro
Prior Auth
Eligibility
Claims 837
Denial Mgmt
70%
Reduction in admin burden
250+
Payer connections
72 hrs
Urgent PA decision timeline enforced
4
CMS FHIR APIs delivered
Capabilities

Everything You Need. Nothing You Don't.

Prior Auth FHIR IG

Full implementation of the HL7 PAS FHIR IG — machine-to-machine PA submission and decision.

Patient Access API

CMS-0057-F compliant Patient Access API with USCDI v3 data model.

Provider Access API

Real-time payer-to-provider data feed for in-network providers.

Payer-to-Payer API

Member data portability across coverage transitions — CMS mandate compliant.

EDI X12 Full Stack

837, 835, 270/271, 278 — all transaction sets, automated, with ERA/EFT posting.

Denial Intelligence

AI-powered denial root cause classification with SNOMED CT and proprietary denial reason codes.

How It Works

From Day Zero to Production

01
Connect
API-based connection to payer portals, clearinghouses, and FHIR endpoints.
02
Automate
Configure PA rules, eligibility triggers, and claims routing with no-code workflows.
03
Adjudicate
Real-time decision support with timeline enforcement and escalation routing.
04
Reconcile
Automated ERA/EFT posting and denial management with root cause tracking.
Integrations

Works With Your Existing Stack

Vorro connects to the systems you already use — with pre-built, production-tested connectors. No rip-and-replace. No months of custom development.

Availity
Change Healthcare
Waystar
Trizetto
Emdeon
NaviMedix
Cotiviti
+ many more

Ready to See It Live?

Talk to a Vorro integration expert about payer integrations for your organization.

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