# Genko Prior Auth

> Genkō Prior Auth is invite-only web software for dental, aesthetics and physiotherapy practices. It turns a planned service and your clinical notes into a draft prior authorization packet; your team reviews, edits, locks and submits it.

Source: https://priorauth.getgenko.com/

Status: early access, by invitation. Synthetic data only. No HIPAA-compliance claim. Nothing is sent to a payer by the software.

## Specialties
- [Dental](https://priorauth.getgenko.com/specialties/dental): Tooth-level findings, radiographs and periodontal charting for crowns, perio and other dental requests.
- [Aesthetics](https://priorauth.getgenko.com/specialties/aesthetics): Functional-impairment documentation for eyelid, nasal, breast, body and scar procedures a payer may cover.
- [Physiotherapy](https://priorauth.getgenko.com/specialties/physiotherapy): Objective measures, visits to date, plan of care and measurable goals for therapy requests.

## How it works
1. **Start a request.** Pick the patient, describe the planned service with its procedure and diagnosis codes, and choose the payer. Your practice's notes about that payer's requirements appear alongside.
2. **Add clinical context.** Paste chart notes, fill in the structured findings for your specialty, and attach supporting files for the record.
3. **Get a draft packet.** Prior Auth writes a clinical justification, a supporting-documentation summary and a request letter, and lists what the payer may expect that you haven't provided.
4. **Review, edit and lock.** Your team edits every section, marks it ready for review and locks it. A locked packet can't change, and it exports as a tagged PDF on your practice letterhead.
5. **Submit, record, appeal.** You send the PDF through the payer's own channel, then record the submission and the decision. If the payer denies or only partly approves, an appeal is drafted from the original packet, the stated reason and any new notes.

## What stays in human hands
- A person picks the patient, the service and the payer.
- Every draft section is editable, and nothing is final until someone locks it.
- Locking is deliberate, asks for confirmation, and can't be undone.
- Nothing is ever sent to a payer by Prior Auth. You download the PDF and submit it yourself.
- The payer's decision is recorded by a person, in their words.
- An appeal is a draft too: reviewed, edited and locked before it goes out.

## Privacy and safety
- **Identifiers removed before drafting.** Patient name, date of birth, member ID, the payer reference and the provider's name are replaced with placeholders before any text goes to the AI model. Dates become an age band or vague timing. The real values are put back locally in your copy.
- **Prompts and answers aren't kept.** We store that a draft was made, how many tokens it used and which prompt version produced it. We don't store the prompt or the model's raw answer.
- **Each practice is separate.** Data is isolated per practice in the database itself, not just in the app. A user from one practice can't read another's requests, even through a bug in a page.
- **Invite-only, with an audit trail.** There is no public sign-up: owners and admins invite people by email. Locks, submissions, exports, generations and member changes are written to an audit log that records ids, not patient details.
- **Limits you can see.** Each practice has a monthly AI budget and plan limits, checked before a draft is generated. If a limit is reached the draft is not made, and the message says why.
- **Built with privacy in mind, not certified.** This is not a HIPAA-compliance claim. There are no business associate agreements in place yet, so it must not be used with real patient information. See the status section below.

## Roles
- **Owner.** Everything an admin can do, plus inviting and removing other owners. Every practice has at least one.
- **Admin.** Invites and removes team members, sees plan, trial and usage under Billing.
- **Provider.** Creates and works requests: context, drafts, edits, locking, outcomes and appeals.
- **Staff.** The same day-to-day access as providers. Staff can't see billing or manage the team.

## Works today
- Dental, aesthetics and physiotherapy have their own code lists and structured findings; other practice types use a generic set.
- The new-request flow, packet drafting, editing, locking and PDF export.
- Recording submission and outcomes, and appeal drafts with as many rounds as you need.
- Invites, four roles, audit trail, monthly AI budget and plan limits.
- Light and dark mode, and screens built for keyboard use.

## Not yet
- Real patient data. It runs on synthetic data only, and no business associate agreements are in place.
- Self-serve sign-up. Practices are set up by invitation and start on a free trial; owners then subscribe in the app (payments run through Stripe). Plans and prices are on the pricing page.
- The connector for AI assistants (Practice plan, read-only request status). It is built but not yet enabled.
- Drafting through an AI assistant. The connector reads status only; drafting through it is planned, with no date.
- Reading uploaded files. They are stored and can be downloaded, but the AI doesn't read them yet; only pasted notes and structured findings are used.
- Languages other than English.
- A production run of the AI gateway. Drafting has been tested end to end with a stand-in model; the live model path hasn't been exercised in production.

## Common questions

**Does it send anything to the payer?**

No. You download the PDF and submit it yourself through the payer's own channel, then record the submission in the app.

**Can it approve a request or guarantee an approval?**

No. It drafts text for your team to check. Payers decide, and no draft guarantees an outcome.

**Can I use it with real patient information?**

No. It is built with privacy in mind but makes no HIPAA-compliance claim: there are no business associate agreements yet, and it runs on synthetic data only.

**Which practices does it support?**

Dental, aesthetics and physiotherapy have their own code lists and structured findings. Other practice types use a generic form.

**What does it cost?**

Every practice starts with a free 14-day trial, then picks a monthly plan. Plans differ only in their monthly limits; the pricing page lists them.

**How do I get access?**

Accounts are by invitation. Request early access and we will say honestly whether it fits yet.

## More
- [Documentation](https://priorauth.getgenko.com/docs)
- [Guides](https://priorauth.getgenko.com/guides)
- [Pricing](https://priorauth.getgenko.com/pricing)
- [For AI assistants and agents](https://priorauth.getgenko.com/agents)
- [Request early access](https://priorauth.getgenko.com/early-access)