Most PA platforms record what the prescriber attested.
NexusLedge validates it.
We verify clinical decisions against real patient data — drug history, diagnosis codes, fill records, step therapy completion. Clinical knowledge sets the rules. AI enforces them at scale.
Clinician-Built. AI-Driven Automation. Validated Compliance.
10
Automated PA stages
Every PA
Validated against evidence
5
Clinical AI capabilities
HIPAA
Compliant by architecture
The Compliance Clock
The 2026 CMS Proposed Rule reshapes PA timelines
The CMS-0062-P Proposed Rule introduces a 24-hour urgent decision mandate and 72-hour standard window, with full NCPDP ePA standards by October 2027. PBMs have a design window — not a compliance emergency — if they act now.
Why the Lighthouse cohort exists →"Most PA platforms record what the prescriber said happened. We built NexusLedge to check whether it actually happened — against claims data, diagnosis codes, and fill records. That's the difference between processing a PA and getting the clinical decision right."
Three Pillars
Clinician-Built. AI-Driven Automation. Validated Compliance.
Every clinical workflow built on clinical expertise, intelligent automation, and validated compliance.
Every pillar traces back to one question: does the system record what the prescriber said, or verify it against what actually happened?
Clinician-Built
Clinical Pharmacy Expertise
Clinical pharmacists designed the platform — the workflows, the assessment logic, the governance model. Domain credibility, not another tech company guessing at healthcare.
⚡AI-Driven Automation
End-to-End Pipeline
10 automated stages, 2 human touches. 12-stage end-to-end PA pipeline.
⚙️Validated Compliance
Governance & Accountability
Every decision verified, auditable, and defensible. Compliance is validated against evidence, not attested on a form.
Founding Lighthouse Partners Program
Co-designing the next year of NexusLedge with 5 PBMs
Founders’ pricing locked for two years. Direct product input. Live in eight weeks. Strictly limited to 3–5 Q2 2026 partners.
Apply to the cohort →Why NexusLedge
Clinician-Built. AI-Driven. Validated.
100%
Audit-Ready
Every action, every AI recommendation, every clinician determination — logged and traceable. Compliance validated, not just attested.
0
Conflicts of Interest
We serve PBMs. We don't compete with them. No parent company processing claims against you.
$0
Enterprise License Fees
Purpose-built for PBMs that can't justify $200K enterprise platforms. Enterprise capability without the enterprise price tag.
100%
Cloud-Native
Enterprise cloud infrastructure. No on-prem installation. Go live in weeks, not quarters.
Solutions
Built for every stakeholder in the PA ecosystem
For PBMs
Your PBM is unique. Your platform should be too. Validated compliance, end-to-end PA automation, and AI your clinicians control.
Learn more →For Prescribers
One portal. Every PBM. Submit, track, and manage prior authorizations from your browser. No fax, no software install.
Learn more →For Health Plans
Require your PBMs to operate on a modern, auditable platform. Every AI decision logged, explainable, and configurable.
Learn more →Ready to modernize your PBM operations?
See how NexusLedge embeds AI into every clinical workflow.
See the Platform