Controlled Substance & PDMP Compliance for Prior Authorization Specialists with Availity
The Problem
Utilization Management practices prescribing controlled substances need PDMP checks, chart documentation, and pattern monitoring — missing any of it is a DEA problem.
What We Build in Availity
AI runs PDMP checks on every controlled-substance order, documents the check in CoverMyMeds, flags concerning patterns, and generates compliance reports — audit-ready, every prescription. Purpose-built for teams running Availity — uses the native API or agent integration so nothing leaves the system of record.
Availity Integration Approach
Audit your Availity configuration
We map the specific Availity objects, custom fields, and workflows the automation needs to touch for your utilization management practice.
Build on the Availity API or agent
Integration happens inside Availity — no data leaves the system, no parallel tool for your team to learn, no license changes.
Human-in-the-loop handoff
Every automation routes exceptions back to a human in Availity with enough context to act — AI handles the 80%, your team owns the judgment calls.
See this running in your Availity instance
30-minute call. We'll look at your actual Availity setup and show exactly how this workflow fits.