Extract prior authorization forms to structured JSON
Prior authorization forms request payer approval for procedures, medications, or equipment before services are rendered. Every payer uses a different form layout. Sensible extracts PA data into validated JSON for utilization management, workflow automation, and denial tracking.
Why prior authorization forms break standard extraction
Payer-specific layouts, mixed clinical fields, and handwritten justifications make PA forms variable.
Each payer designs its own PA form with different field arrangements. Sensible adapts to each layout while enforcing a consistent schema.
PA forms include free-text sections describing medical necessity. Sensible extracts key clinical data from the narrative.
PA forms require drug names, NDC codes, dosages, CPT codes, and quantities with exact precision. Sensible validates each extracted code.
Fields we extract
Extract any data you need from prior authorization forms into your desired output schema
Patient name, DOB, member ID, group number, requesting provider name, NPI, facility name, payer name, plan type
Primary diagnosis (ICD-10), secondary diagnoses, requested procedure (CPT), requested medication (NDC/drug name/dosage), clinical justification
PA request number, submission date, urgency (standard/expedited), requested service dates, units requested, estimated cost
Durable medical equipment authorization form for wheelchairs, CPAP, and similar devices.
Pre-authorization request for surgical or diagnostic procedures.
Insurer form requesting authorization for non-formulary or specialty medications.
Supported PA form types
Sensible processes prior authorization forms from any payer, many available in our healthcare template library. Custom payer configurations build in hours.
UnitedHealthcare, Anthem, Aetna, Cigna, Humana, BCBS affiliates, regional health plans
Medicare (MAC-specific), Medicaid (state-specific), Part D, CVS Caremark, Express Scripts, OptumRx
Common Questions
Details on Sensible PA form extraction.
Sensible captures requesting provider name, NPI, practice name, phone, fax, and servicing facility details. Patient information including member ID and group number is also extracted.
Yes. Sensible extracts the payer name, plan type, authorization number, required documentation checklist, peer-to-peer review requirements, and appeal deadlines.
Sensible extracts the requested medication name, dosage, frequency, quantity, NDC code, or the requested procedure with CPT code, diagnosis codes, and clinical rationale.
Yes. Sensible captures the authorization decision (approved, denied, pending), effective dates, authorized units or duration, and any conditions or restrictions.
Yes. Sensible sends extraction results to your webhook endpoint when processing completes. You can also poll the API for status.
Yes. Sensible flags extractions with low confidence for human review. You can configure review thresholds and workflows.
Sensible is SOC 2 Type II certified and HIPAA compliant. Data is encrypted in transit and at rest.
Documents are deleted after 30 days by default. You can configure shorter retention periods or request immediate deletion via API.
Yes. Sensible offers a free tier with 50 documents per month. No credit card required to start.
Sensible uses per-document pricing for predictable costs. No token-based billing or usage surprises. Volume discounts are available for higher throughput.
Sensible provides REST APIs and SDKs for Python and Node.js. Most integrations take a few hours. Webhooks, Zapier, and direct API calls are all supported.
Sensible processes PDF, PNG, JPG, and TIFF files. PDFs can be native or scanned.
Accuracy depends on document quality and configuration. Most production deployments achieve 95%+ accuracy with proper validation rules and confidence scoring.
Most documents process in 2 to 10 seconds depending on complexity and page count.