The criterion exists. The delay is finding it.
The coverage criterion is written down. Finding it, matching it, and proving it is where the hours and appeals go — SphereIQ does it in seconds, cited and PHI-masked.
How do providers and payers use SphereIQ?
They deploy SphereIQ as a governed Company Brain over clinical policy, coverage criteria, and care protocols; agents for prior-authorization triage, coverage and medical-necessity checks, and documentation assembly; and PHI-aware governance with a signed, immutable audit trail, aligned to HIPAA. Every answer is cited to the policy, criterion, and page.
Same platform. Pre-built for your world.
Vertical editions ship with a pre-built Twin schema, agent templates, and compliance packs for the industry — so deployment starts at mile ten, not mile zero.
Policy, criteria & protocols
Clinical policy, coverage criteria, plan documents, and care protocols answerable in seconds — every answer cited to the policy, criterion, and page it came from.
Prior auth, coverage, docs
Prior-authorization triage, coverage and medical-necessity checks against criteria, and documentation and appeals-evidence assembly — governed on every action.
PHI-aware, HIPAA-aligned
PII and PHI masking in the request path, access scopes that inherit source permissions, and a signed, immutable audit trail — self-hosted where residency demands it.
Faster determinations. Defensible every time.
Every response cites the clinical policy, coverage criterion, and page it came from — retrieved from your systems, not generated from memory. PII and PHI masking and guardrail checks run in the request path before the model responds. And every retrieval and governed action is captured in a signed, immutable audit trail.
Asked in every evaluation
How is PHI protected?
Does it replace our EHR or care-management system?
Where do organizations usually start?
The policy is written. The answer should be instant.
Start with the coverage or prior-authorization workflow that carries the most delay.