Healthcare Context Brain™

Prior Authorization Intelligence
Grounded in Certified Evidence

The first PA simulation engine that predicts approvals in under 5 minutes — zero hallucination, fully grounded in authoritative clinical evidence and payer-specific coverage logic.

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<5 min PA simulation, point of prescribing
>90% First-pass approval rate target
$42.5B Top 15 Medicare drugs — PA friction market
Zero PHI exposure — enforced by architecture
Our Mission
Help humans age with grace — one right medication, at the right time, without the fight.
The average US physician completes more than 45 prior authorization requests every week. Across tens of millions of requests annually — Medicare Advantage alone logged 53 million in 2024 — patients with diabetes, cancer, autoimmune disease, and cardiovascular conditions wait days, or give up entirely.

OPEX AI Consulting exists to eliminate that friction. Not by replacing clinical judgment — but by grounding every PA decision in the same FDA-approved truth the drug label has always contained. The rules were always there. We make them computable.
Who We Serve

Three Buyers. One Engine.

The Healthcare Context Brain™ delivers different value to each stakeholder — powered by the same proprietary engine.

🏥

Health Plans & Payers

The MA Regulatory Pincer

Between CMS-0057-F (Medical) and the October 2027 Pharmacy Mandate, MA and D-SNP plans are under fire for slow approvals and "black box" denials. PA processing costs $11–$40 per claim — and manual review is no longer just expensive. It is a compliance risk.

→ Unify Medical (FHIR) and Pharmacy (NCPDP) logic into a single Context Brain. Maintain 5-star ratings by eliminating care delays.
💊

Pharmaceutical Companies

Pain: 30% Rx Abandonment

One in three patients abandons a prescription after a PA denial. Your drug gets approved by FDA — then blocked by payer paperwork.

→ Predict denials before they happen. Protect your formulary position.
🩺

Health Systems & Providers

Pain: Physician Burnout

Physicians spend 14+ hours per week on administrative tasks. PA is the single largest driver. It pulls time from patients.

→ Know before you prescribe. First-pass approval, every time criteria are met.
The Architecture

How It Works

A federated two-layer system. Proprietary clinical intelligence lives in the cloud. Patient data never leaves the EHR.

Step 01

EHR Query

Our engine acts as a local listener, pulling the discrete data elements required by both USCDI v1 (FHIR / Medical) and NCPDP SCRIPT (Pharmacy) — before any data moves anywhere.

Step 02

Proprietary Intelligence Layer

The Context Brain™ cross-references medical claims history (via the Provider Access API) with current formulary status (via NCPDP Formulary & Benefit v60) for a 360-degree approval prediction.

Step 03

Evidence-Grounded Match

Every recommendation is grounded in certified clinical evidence — indication, contraindication, step therapy, dosing. Zero hallucination by design.

Step 04

PA Recommendation + CMS-Ready Audit Trail

Result delivered in under 5 minutes. Every decision links directly to NCD/LCD citations, clinical evidence, and the specific patient parameters used — so what flows downstream via API is already accurate, approved, and audit-ready.

Why OPEX AI

What Makes This Different

Most PA tools use general-purpose AI that hallucinates outdated drug data. We don't.

Authoritative Clinical Evidence as Ground Truth

Every drug decision in our proprietary engine is sourced from certified, continuously updated regulatory and clinical data — indications, contraindications, black box warnings, interactions. Updated same day as label changes.

Deterministic, Not Probabilistic

The same clinical query returns the same answer every time. No variance. No hallucinated payer rules. Our proprietary reasoning engine is auditable, deterministic, and defensible in a regulatory context.

Zero PHI Exposure by Architecture

Patient data stays inside the EHR on-prem. The system never sees real patient records. HIPAA compliance is not a policy — it is enforced by the architecture itself.

Customer Data Never Trains Our Model

Your payer rules, your patient populations, your formulary decisions — none of it is used to train or fine-tune anything. Ever. Your proprietary data stays yours.

Built for Dual-Eligible Complexity

D-SNP logic is notoriously fragmented. Our engine reconciles Medicare and Medicaid coverage rules in real time — ensuring the most vulnerable patients get the right medication without administrative ping-pong between payers.

Zero Hallucination by Design

Every clinical and coverage decision is grounded exclusively in authoritative regulatory data — not generated, interpolated, or inferred. Here is exactly where our intelligence comes from.

FDA / NIH
FDA Prescribing Information

Official drug labeling: indications, contraindications, black box warnings, dosing, and drug interactions — updated same day as label changes.

NIH / NLM
DailyMed

NIH/NLM's structured XML repository of all FDA-approved drug labels. The authoritative machine-readable source for all drug data in the Context Brain™.

CMS
National Coverage Determinations (NCDs)

CMS-issued Medicare-wide coverage policies that govern whether items and services are covered under Part A and Part B.

CMS / MACs
Local Coverage Determinations (LCDs)

Jurisdiction-level coverage policies issued by Medicare Administrative Contractors (MACs) — the granular layer that determines most real-world PA outcomes.

CMS
Medicare Part D Formulary Files

CMS-published plan-level formulary data: tier placement, quantity limits, step therapy requirements, and PA flags — updated plan year.

CMS
Medicaid National Drug Rebate Program Data

CMS drug product and rebate data used to cross-reference dual-eligible (D-SNP) coverage logic across Medicare and Medicaid.

NCPDP
NCPDP SCRIPT v2023011

The CMS-mandated electronic prescribing and pharmacy PA transaction standard underpinning the October 2027 pharmacy interoperability mandate.

HL7 / CMS
HL7 FHIR R4 / PARDD API

The CMS-mandated interoperability standard for medical prior authorization (CMS-0057-F). Our engine is built FHIR-native from day one.

Compliance Readiness

The 2027 Dual-Mandate Checklist

Two regulatory deadlines. One converging logic layer. Is your plan ready for both the FHIR (Medical) and NCPDP (Pharmacy) mandates?

Phase 1
Medical Interoperability
Deadline: January 1, 2027
  • API Deployment: Is your FHIR-based Prior Authorization API (PARDD) live for medical items and services?
  • Provider Access: Can your in-network providers query the last 5 years of patient clinical data in real time?
  • Denial Transparency: Are you providing specific NCD/LCD-mapped denial reasons via the Patient Access API — not generic codes?
Phase 2
Pharmacy Integration
Deadline: October 1, 2027
  • NCPDP SCRIPT Upgrade: Have you transitioned from SCRIPT v2017071 to v2023011 — required for all 2027 pharmacy workflows?
  • F&B + RTPB: Formulary & Benefit v60 and Real-Time Prescription Benefit v13 implemented for point-of-care cost transparency?
  • Accelerated Adjudication: Are you prepared for 72-hour (standard) and 24-hour (urgent) drug PA turnarounds for Part D and Medicaid?
Not sure where your plan stands?
We offer a complimentary 30-minute MA & D-SNP readiness assessment — a structured review of your PA posture against both 2027 mandates. No sales pitch.
Request Assessment →
Mohan Nadarajah
Founder & CEO, OPEX AI Consulting Services LLC

Mohan brings 30 years of frontline healthcare commercial experience — from pharmaceutical sales and market access strategy to payer operations and CMS regulatory compliance. He has worked across every layer of the US healthcare system: at Merck, Amgen, Mayo Clinic, IQVIA, and Cytokinetics, in therapeutic areas spanning oncology, immunology, cardiovascular, respiratory, and diabetes.

The Healthcare Context Brain™ is not a technology looking for a problem. It is 30 years of operational pattern recognition — why physicians prescribe what they prescribe, how payers construct PA criteria, what makes a drug succeed or fail at the formulary level — encoded as a proprietary, computable intelligence system.

Merck 1993–2009 Mayo Clinic IQVIA Amgen 2013–2021 Cytokinetics Opex.ai LLC 2022–present
  • Prior authorization workflows and payer operations — commercial, Medicare, Medicaid
  • Pharmaceutical market access — formulary strategy, step therapy, exception protocols
  • CMS regulatory compliance — CMS-0057-F, Part D, TEFCA, HIPAA
  • Specialty pharmacy operations — oncology, immunology, rare disease
  • Multi-stakeholder decision logic — provider, payer, patient, pharma, regulator
  • Hidden incentive architectures — why payers deny, why physicians abandon
  • Patient journey mapping — birth to end of life, disease progression, treatment selection
  • Therapeutic expertise — oncology, autoimmune, cardiovascular, diabetes, respiratory, osteoporosis

Ready to See It?

We are currently in strategic partnership conversations with health plans, pharmaceutical manufacturers, and health systems. Briefings are by invitation.

Request a Briefing →
mohann@fjfrontier.com  ·  Austin, TX  ·  OPEX AI Consulting Services LLC