ClarityCare AI

ClarityCare AI is a New York-based healthcare software company that sells AI agents for utilization management (UM) to health insurance organizations. Its product, branded Electra, is positioned as an agentic workforce that takes a prior-authorization request from intake through to a recommendation. According to the company's website, the workflow has four stages: intake, where requests arriving through a provider portal, clinical fax, or provider phone call are consolidated into a single case; organize, where the member is matched, the prior authorization is confirmed, and files are classified; evaluate, where clinical criteria and benefits are checked together and exceptions flagged; and deliver, where a recommendation, cited rationale, and audit trail are produced for human review.

The company frames Electra as a trained agent rather than a conventional software tool, describing it as reading documents, applying guidelines, writing rationales, and learning under expert supervision. Each agent logs its reasoning and cites guidelines, which the company links to CMS-0057-F and NCQA compliance requirements and to state and federal turnaround-time rules. The website states the product is HIPAA compliant and SOC 2 Type II certified, and that agents are integrated into existing UM systems using a customer's existing access and policies.

Beyond prior authorization, ClarityCare AI markets adjacent applications of its agentic workforce: payment integrity (claims and denial reviews), clinical programs (care management, risk adjustment, and transitions of care), and population analytics using prior-authorization data as an early signal of member risk. Entrepreneurs First lists ClarityCare AI in its portfolio; the EF listing page itself does not provide additional company-specific detail beyond the portfolio directory.