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ARKA Clinical Decision Support is designed to meet all four criteria for Non-Device CDS under FD&C Act §520(o)(1)(E) and FDA's January 2026 final guidance on Clinical Decision Support Software. Recommendations support, not replace, the clinician's judgment. Every recommendation is anchored in a published guideline or peer-reviewed source, with the basis available for independent review. CLIN emphasizes imaging appropriateness at order entry.
This recommendation is intended to support, not replace, clinical judgment. It is generated by ARKA, software designed to meet the four criteria for Non-Device Clinical Decision Support under FD&C Act §520(o)(1)(E) and FDA's final guidance on Clinical Decision Support Software (January 2026). The clinician is responsible for the final decision.
For Utilization Management
Your team reviews medical necessity by hand against criteria that often conflict with clinician-facing evidence — and CMS-0057-F now compresses turnaround to 72 hours urgent / 7 days standard. Manual prior auth takes ~24 minutes each, physicians and staff burn ~13 hours a week on it, and 80.7% of appealed denials are overturned — a signal the criteria themselves are misfiring.
Your scorecard
The KPIs your board and leadership team track — where imaging leakage shows up first.
The problem
Benchmark-backed pain points tied to the metrics you own.
24 min / PA
~24 minutes per manual PA, ~13 staff hours per physician per week, and chronic turnover.
80.7% overturned
When 80.7% of appealed denials are overturned, wrong denials are creating rework, abrasion, and risk.
72h / 7d
CMS-0057-F mandates 72h urgent / 7d standard decisions and a specific denial reason beginning 2026.
The fix
Each lever maps to a pain above — same order, same grid, so the pairing is obvious.
ARKA-INS runs the identical AIIE the ordering clinician saw — eliminating payer-vs-clinician criteria conflict and the appeals it spawns.
Da Vinci PAS enables real-time auth decisions instead of multi-day queues — built for the new SLAs.
~60% less manual review time: auto-clear the clearly appropriate, reserve reviewers for genuine edge cases, and run a defensible gold-card program.
The numbers
Modeled or published figures — labeled with their basis.
~60%
manual review time reduced
modeled
72h / 7d
CMS-0057-F SLAs met
Da Vinci PAS live
44%
of gold-card programs target imaging
industry data
Evidence
What we bring to the conversation — sourced from the ARKA buyer playbook.
Pushback
The concerns we hear most — and how we address them.
ARKA-INS is a Da Vinci PAS-compliant layer between the EHR and the payer system — it feeds better, standardized data without replacing the payer's tool.
It is the same evidence-based engine with a SHAP audit trail on every decision — more consistent than manual review, with humans kept in the loop for edge cases.
Gold-carding rewards the few who already pass; ARKA raises the baseline for everyone and gives you the appropriateness data to run the program defensibly.
Your agenda
Three questions to put on the table — we'll answer with your data, not generic slides.
Question 1: What is your median auth turnaround versus the new 72h/7d SLA?
Question 2: What is your overturn-on-appeal rate?
Question 3: How many FTEs run manual imaging review today?
Explore
Jump into the modules most relevant to your seat.
Process walkthrough mapping your current auth workflow, showing exactly where ARKA inserts and what it replaces.
Quick answers
No — it automates the clearly-appropriate and routes true edge cases to humans, with full audit trails.
Yes — live Da Vinci CRD/DTR/PAS endpoints today.
Process walkthrough mapping your current auth workflow, showing exactly where ARKA inserts and what it replaces.
