Streamline prior authorization workflows, cut costs, and elevate member care with intelligent, AI-driven automation.
Vital Data Technology named a representative vendor in the
Gartner® Market Guide for Intelligent Prior Authorization for U.S. Healthcare Organizations, February 2026
Affinitē Utilization Management (UM) redefines utilization management through AI-driven intelligent automation and advanced analytics that power real-time, data-driven decisions. Our innovative Benefit Query Engine delivers instant visibility into eligibility and benefits, enabling proactive and precise determinations for every authorization.
Built for the future of healthcare, the platform adapts to evolving regulatory demands with configurable, intelligent tools that enhance oversight and transparency. By connecting providers, members, and care teams through a unified digital ecosystem, Affinitē UM transforms utilization management into a predictive, collaborative process – driving smarter decisions and better outcomes across the continuum of care.
Intuitive design and smart configuration for maximum productivity.
Intelligent rules engine
dramatically streamlines
UM processes.
360-degree visibility
and compliance across
all lines of business.
Designed specifically for health payers, Affinitē UM simplifies workflows, automates complex benefit verifications, and eliminates time-consuming administrative tasks. This frees valuable clinical staff to target only those complex cases that require their expertise. Intelligent automation streamlines administrative actions so your team can operate at the top of their licensure.
One-click referrals reduce review times from over an hour to less than 15 minutes.
Our user-friendly design streamlines authorization management by up to 40%.
Instant insights into member benefits; track statewide
compliance in real-time.
Our user-friendly design streamlines authorization management by up to 40%, saving significant time and money.
Plan-specific accommodations, turnaround time compliance, benefit configuration, and auto auth rules.
All authorization-related data is housed in one platform to sync care management, care gap, and other clinical systems.
Affinitē UM’s Benefit Query Engine is a breakthrough, AI-powered rules engine that redefines how authorizations are managed. It intelligently identifies, triages, and routes requests in real time – adapting to benefit design and clinical complexity with unmatched precision. The result? Seamless process adherence, lightning-fast efficiency, and smart auto-approvals that set a new standard for utilization management.
Affinitē UM is your trusted partner in navigating the upcoming CMS-0057-F mandates, effective January 1, 2027. With our cutting-edge platform, your team can confidently stay ahead of regulatory requirements, simplifying compliance while unlocking new opportunities for success.
Designed for precision and efficiency, Affinitē UM streamlines complex processes, ensuring your organization isn’t just compliant but thrives in an evolving regulatory landscape.
Discover how CMS's push for uniform prior authorization policies and automation can improve efficiency, increase member satisfaction, and reduce administrative burdens for health plans.
Payers are working to overhaul prior authorization, according to a recent announcement from AHIP. Discover how Vital Data Technology is leading the effort with advanced, intelligent solutions.
Affinitē Utilization Management embeds real-time, rules-driven benefit and clinical logic directly into the authorization workflow, ensuring decisions are consistent, timely, and fully auditable. Every determination is traceable to underlying benefit rules and clinical criteria, supporting regulatory reporting, audits, and appeals while reducing compliance risk by design.
Affinitē Utilization Management evaluates authorization data in real time at intake, enabling immediate benefit determinations and eliminating manual lookups, downstream corrections, and rework. The platform routes only complex or high-risk cases to clinical review, significantly reducing turnaround times without sacrificing accuracy or oversight.
Affinitē Utilization Management automates high-volume, low-risk authorizations end to end, allowing clinicians to focus on cases that require medical judgment. Intelligent routing and configurable workflows reduce administrative burden, lower cost per authorization, and improve staff satisfaction.
Unlike solutions that only automate simple eligibility checks or standard services, Affinitē Utilization Management automates full benefit determination. The platform applies comprehensive coverage logic in real time, producing immediate, defensible decisions rather than limited rule-based approvals.
Affinitē Utilization Management operates on a single platform alongside care management, sharing data, rules, and decision logic. This eliminates silos, ensures continuity across the care lifecycle, and enables seamless coordination between utilization review and care management activities.
Yes. Affinitē Utilization Management is designed for interoperability, integrating with clinical systems, eligibility and benefits platforms, and third-party vendors without requiring custom workarounds. This ensures seamless data exchange and supports regulatory interoperability requirements.
Affinitē Utilization Management delivers real-time, accurate determinations that reduce delays, minimize appeals, and eliminate provider friction. Members benefit from faster access to care, while providers gain more predictable and transparent authorization outcomes.