Y Combinator S26 Applicant

Prior authorization
is broken. We're fixing it.

Physicians lose 13+ hours per week to prior authorization. PA Sherpa uses AI to reclaim that time, built for independent specialty practices that can't afford enterprise solutions.

$98B
Annual PA administrative cost
13 hrs
Per physician per week on PA
80.7%
Of PA denials overturned on appeal
3%
Software penetration today

Sources: AMA Prior Authorization Physician Survey (2024), CAQH Index (2023), KFF Medicare Advantage Denial/Appeal Analysis (2024)

Your staff spends more time on paperwork
than patient care

Prior authorization is the most hated process in healthcare. Insurance companies require pre-approval for procedures, and the burden falls entirely on medical practices.

Phone, Fax, and Four Portals

Each payer has a different submission process. Staff toggle between phone holds, fax machines, and payer-specific web portals all day.

Patients Left in the Dark

Patients call the office every 2 days asking "was my MRI approved?" Your front desk becomes a human status tracker for insurance processes.

Denials Cost Revenue

When PAs are denied, practices lose procedure revenue, even though 80.7% of denials are overturned on appeal (KFF, 2024). Most small practices never appeal because they lack the time and expertise.

PA Sherpa: three tools, one platform

Everything your practice needs to submit, track, and win prior authorizations. Powered by AI trained on clinical guidelines and payer requirements.

01

Smart PA Submission

Enter patient and procedure info once. Our AI analyzes clinical data, identifies missing documentation, and optimizes the submission for maximum approval likelihood.

  • AI-generated approval likelihood score
  • Auto-detected missing clinical documentation
  • Suggested clinical language that matches payer criteria
  • One unified submission workflow for all payers
02

Real-Time Patient Tracker

Give patients a simple link to check their PA status anytime. No login required, no phone calls to your office.

  • Unique tracking URL per patient
  • Visual timeline of every status change
  • SMS and email notifications on updates
  • Plain-language explanations (no insurance jargon)
03

AI Denial Appeals

80.7% of PA denials are overturned on appeal, but most small practices never appeal. Our AI generates clinical appeal letters and peer-to-peer prep briefs in seconds.

  • One-click appeal letter generation
  • Peer-to-peer talking points for physicians
  • Clinical guideline citations (ACC, AHA, NCCN)
  • Denial pattern analysis across your practice

From hours of busywork to minutes

PA Sherpa replaces your Excel spreadsheet, your fax machine, and your "on hold with Aetna" playlist.

1

Enter the basics

Patient info, diagnosis, and procedure. That's it. Our guided form handles the rest.

2

AI optimizes

PA Sherpa analyzes payer requirements and clinical data to maximize approval probability.

3

Submit & track

One click to submit. Real-time status updates for your team and patients.

4

Appeal if needed

Denied? AI generates your appeal letter with clinical citations in under 30 seconds.

CMS is on your side

The CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) already mandates faster PA decision times as of January 2026, and requires payers to support standardized FHIR APIs for electronic PA submission by January 2027.

We're building on FHIR R4 and Da Vinci PAS standards now, so your practice is ready the moment payers are required to connect.

What's changing

Jan 2026: Payers must respond to expedited PAs within 72 hours, standard within 7 days
Jan 2027: Payers must support FHIR-based electronic PA submission via standardized APIs
Ongoing: Denial reason transparency and real-time status reporting requirements

Independent specialty practices

3-10 provider practices in high-PA-volume specialties. Too small for enterprise solutions, too busy for broken workflows.

Right-sized

Enterprise PA tools cost $50K+ and take 6 months to implement. PA Sherpa is live in a day for a fraction of the cost.

Specialty-aware

Our AI understands the clinical guidelines, CPT codes, and payer requirements specific to your specialty.

Cardiology Rheumatology Oncology Neurology Orthopedics

No IT department needed

Cloud-based, works in any browser. No hardware, no EHR integration required to start. Just log in and submit your first PA.

Stop losing hours to prior auth

PA Sherpa launches summer 2026. Get early access and help shape the product for practices like yours.

Free for beta practices. No credit card required.