Medicare Advantage prior authorization requests were fully or partially denied in 2024.
Human-Led Access Support For Specialty Clinics
Treatment Denials
Have a Human Cost.
BOOK A CLINIC ACCESS REVIEW 
[OUR PHILOSOPHY]
Tech handles
the friction.
Humans handle
the relationship.
Every other ops platform promises AI automation. We promise something harder: Real People who know your patients, your payers, and your practice—and who fight like it’s personal.
Our technology handles the data, the tracking, and the intelligence layer. Our expert Access-Team handles the calls, the escalations, and the appeals that require a human voice and clinical expertise.
Specialty Clinics Are Losing the Fight They Didn’t Sign Up For.
"The payer system wasn't built to help patients get care. It was built to delay, deny, and exhaust the people fighting for them."
The Access Gap Is Not Administrative.
It Is Human.
A prescription should be the start of treatment. Too often, it becomes the start of a fight. Patients wait. Providers chase paperwork. Staff lose hours to portals, faxes, payer rules, denials, missing criteria, and follow-up calls. In specialty care, delay can mean worsening symptoms, frustration, or settling for a therapy that was not the provider’s first clinical choice.
Only 11.5% of Denied Prior-Authorizations appealed in 2024 as per CMS Data Reports for Medicare Advantage.
Denied requests appealed.
Appealed denials overturned.
Physicians reporting prior authorization delays necessary care.
Sources: KFF analysis of 2024 CMS Medicare Advantage data; CMA report of AMA survey findings, June 2024.
THE ROXI HEALTH MISSION
We exist to turn prescription
into treatment.
Roxi Health is a human-first specialty access solution helping clinics reduce prior authorization delays, fight denials, and move patients from prescription to treatment faster.
Our Clinical Solutions
We bridge the gap between prescription and treatment through our specialized Access-Team offering operational support to your clinic teams.
Access Intake
INITIAL ASSESSMENT
We organize payer requirements, therapy documentation, and patient eligibility from the very first consultation to ensure a smooth start.
Prior Authorization Support
WORKFLOW MANAGEMENT
Prepare and manage complex access workflows with payer-specific discipline, reducing administrative friction and submission delays.
Appeals & Patient Access
STRUCTURED NAVIGATION
Support structured appeals, affordability pathways, and specialty pharmacy coordination to restore patient access to clinical care.