Apotheke: Moving Beyond Static Question Sets to Intelligent Clinical Criteria
Prior authorization workflows have long relied on rigid decision trees and static questionnaires. These predefined paths rarely account for nuanced cases or evolving treatment standards. As a result, clinical judgment is constrained by inflexible logic, edge cases are overlooked, and reviewers spend more time navigating forms than evaluating care.
Introducing Apotheke
We’re excited to announce a new release of Apotheke, an AI-powered criteria management service redefining how prior authorization decisions are made.
Apotheke allows organizations to ingest clinical criteria in any format and automatically apply them during reviews. It replaces static, checkbox-driven workflows with context-aware clinical intelligence, surfacing relevant evidence exactly when reviewers need it.
With Apotheke, organizations can update criteria with efficiency and ease, without rebuilding decision trees or question sets. This allows clinical teams to work from the most current clinical standards while maintaining organizational audit trails for compliance and quality assurance.
Our AI model never trains on your data, ensuring full protection of proprietary clinical policies and decision frameworks. Apotheke is a secure, organization-only repository for your critical clinical assets.
How It Works
- Upload Your Criteria
Upload clinical policy documents, medical necessity guidelines, step therapy protocols, or formulary rules in any format. - AI-Powered Interpretation and Centralized Clinical Repository
Apotheke ingests and extracts the clinical logic embedded in your documentation, preserving structure and context. Your criteria are stored in Apotheke’s searchable, editable clinical repository, making updates simple and traceable. - Integrated Case Evaluation and Recommendation
During review, Amphitheater’s core AI decision engine, Asklepios, identifies relevant criteria from Apotheke and evaluates each case against the appropriate standards, specific to your active policies. The system generates approve/deny recommendations with clinical rationale mapped directly to documented guidelines.
What This Means For Your Organiztion
Consistency At Scale
Every case is evaluated against the same validated criteria, eliminating variability driven by individual reviewer experience.
Touchless Automation/ Faster Decision Cycles
Clear-cut cases move through the queue with minimal manual intervention, freeing capacity for complex, high-judgment reviews.
Full Control of Your Policies
You don’t need to restructure years of carefully developed clinical documentation to fit a vendor template. Updates go live instantly, without rebuilding logic trees or waiting for implementation cycles.
Transparent Decision Support
Every recommendation is supported by clear, traceable reasoning tied to specific sections of your criteria. Reviewers can easily validate, adjust, or override decisions when appropriate.
Apotheke represents a shift away from static workflows and toward adaptive, explainable, and scalable clinical decision support designed to help organizations deliver faster, more consistent, and more defensible prior authorization outcomes.
Our team is ready to answer your questions and explore how Apotheke can support your organization’s clinical and operational goals.
Request a demo, schedule a consultation, or connect with our team today.