Central for Rheumatology

Every biologic approval means proving the two drugs that already failed.

Step therapy documentation assembled per patient, infusion authorisations on a renewal clock, and specialty pharmacy chasing that never ends. Central does the assembling and the chasing.

Your data stays yours. Encrypted in transit & at rest, no training on your data.

Central for Rheumatology

Every biologic approval means proving the two drugs that already failed.

Step therapy documentation assembled per patient, infusion authorisations on a renewal clock, and specialty pharmacy chasing that never ends. Central does the assembling and the chasing.

Your data stays yours. Encrypted in transit & at rest, no training on your data.

YOUR WEEK

We already know where your week goes.

Three things every ob/gyn practice we speak to describes, usually in the first ten minutes.

  1. Step therapy is a documentation exercise

The payer wants methotrexate tried, at dose, for a duration, with the response recorded. It is all in the chart. Extracting it per request is the job.

AI AGENT

  1. Infusion versus pharmacy benefit

The same biologic goes through the medical benefit as an infusion or the pharmacy benefit as a self-inject, and the authorisation path is completely different.

AI AGENT

  1. Annual renewals that arrive all at once

Biologic authorisations renew, and if nobody is tracking them the patient finds out at the pharmacy counter.

A 24-hour expedited review only holds if someone is watching it. Otherwise it quietly becomes a standard 72-hour review and treatment slips a week.

AI AGENT

HOW WE WORK IT

The whole chain, not the first link.

Every step says whether an agent or one of our specialists did it. Nothing clinical or contentious is left to software.

01

Regimen and benefit identified

We determine whether the agent runs through the medical or pharmacy benefit before anything is filed.

Step Therapy

02

Safety Screening

03

Denial Appeal

04

Renewal Tracking

05

01

Regimen and benefit identified

We determine whether the agent runs through the medical or pharmacy benefit before anything is filed.

Step Therapy

02

Safety Screening

03

Denial Appeal

04

Renewal Tracking

05

NOMENCLATURE

You will not be explaining oncology & hematology to us

Our specialists are trained on your work before they touch it. This is the starting point, not the finished training.

CODES WE ALREADY KNOW

J1745 infliximab

J1745 infliximab

J3262 tocilizumab

J3262 tocilizumab

J9312 rituximab

J9312 rituximab

96413 infusion, first hour

96413 infusion, first hour

99070 / J-code biologic supply

99070 / J-code biologic supply

86580 TB skin test

86580 TB skin test

WHERE IT GETS DENIED

Methotrexate trial duration too short

Methotrexate trial duration too short

Response to prior therapy not documented

Response to prior therapy not documented

TB screening missing before biologic

TB screening missing before biologic

Non-preferred biosimilar selected

Non-preferred biosimilar selected

Renewal filed after expiry

Renewal filed after expiry

SYSTEMS YOU PROBABLY RUN

eClinicalWorks

eClinicalWorks

Epic

Epic

ModMed Rheumatology

ModMed Rheumatology

athenahealth

athenahealth

Availity

Availity

Specialty pharmacy hubs

Specialty pharmacy hubs

PAYER FRICTION WE EXPECT

Step therapy with documented failure

Step therapy with documented failure

Biosimilar-first mandates

Biosimilar-first mandates

Annual re-authorisation

Annual re-authorisation

Split medical versus pharmacy benefit

Split medical versus pharmacy benefit

THE SPLIT

The agent does one half. Our people do the other.

Everything repetitive.
Everything repetitive.

Works payer portals and practice systems directly

Works payer portals and practice systems directly

Calls payers and navigates phone trees

Calls payers and navigates phone trees

Assembles documentation out of the chart

Assembles documentation out of the chart

Recovers when a vendor redesigns a page

Recovers when a vendor redesigns a page

Runs nights, weekends and holidays

Runs nights, weekends and holidays

Judgment and exceptions

Approves every workflow before it runs

Handles denials, appeals and peer-to-peers

Signs in where a payer demands multi-factor

Takes the call that needs a human voice

Makes the cost conversation, never a bot

Judgment and exceptions

Approves every workflow before it runs

Handles denials, appeals and peer-to-peers

Signs in where a payer demands multi-factor

Takes the call that needs a human voice

Makes the cost conversation, never a bot

Judgment & exceptions

Approves every workflow before it runs

Handles denials, appeals and peer-to-peers

Signs in where a payer demands multi-factor

Takes the call that needs a human voice

Makes the cost conversation, never a bot

PROOF

Most Al vendors have never worked a denial.

Wing has staffed the back office of 10,000 companies. Central is the agent layer built on top of people who already know what a peer-to-peer is.

Provida Family Medicine

Needed clinic operations streamlined

50% faster admin ops

35% fewer billing errors

25% faster claims

They have a robust platform that makes communicating with our VA incredibly easy. It also helps that they act quickly and are incredibly responsive.

Christine Mulvey

Director of Marketing, charlesgate.com

COMMON QUESTIONS

COMMON QUESTIONS

Questions, before you book.

Can you pull step therapy evidence out of our EHR?

That is most of the work in rheumatology. The prior trials, doses and responses are in the chart already — the delay is in assembling them into the payer's format, which is exactly what agents are good at.

Do you track annual renewals?

Yes, against the expiry date rather than a reminder. The failure mode we see most often is a patient discovering a lapsed authorisation at the pharmacy counter.

How quickly can we start?

One call is your whole part of the setup. We watch how the work is done today, build the workflow, and your lead approves every step before anything runs. Typical time to go live is around 48 hours for the first service.

What happens to patient data?

A BAA is signed before a single patient record is touched. Central is SOC 2 certified, HIPAA compliant and ISO 27001, work runs on managed devices with a full audit trail, and credentials stay encrypted and are never shared.

Can you pull step therapy evidence out of our EHR?

That is most of the work in rheumatology. The prior trials, doses and responses are in the chart already — the delay is in assembling them into the payer's format, which is exactly what agents are good at.

Do you track annual renewals?

Yes, against the expiry date rather than a reminder. The failure mode we see most often is a patient discovering a lapsed authorisation at the pharmacy counter.

How quickly can we start?

One call is your whole part of the setup. We watch how the work is done today, build the workflow, and your lead approves every step before anything runs. Typical time to go live is around 48 hours for the first service.

What happens to patient data?

A BAA is signed before a single patient record is touched. Central is SOC 2 certified, HIPAA compliant and ISO 27001, work runs on managed devices with a full audit trail, and credentials stay encrypted and are never shared.

GOVERNANCE

Built for PHI, and for audit.

Enterprise healthcare buyers need more than a badge. These are the controls that keep the operating model defensible to compliance, security and your payers.

BAA before access

Executed before any patient data is touched. Pilots run on test accounts until it is in place.

Workflow approval

No workflow runs in production until your named lead has reviewed and approved every step.

Credential protection

Credentials are stored encrypted, used inside controlled sessions and never shared between personnel.

Action history

Every action is attributable to an agent or named specialist, with a full audit trail for complete visibility.

Controlled access

Managed devices, role-based access and least-privilege scoping to only the systems a workflow needs.

Defined escalation

The conditions under which an agent stops and a person takes over are configured with you, not inferred.

Central Get your hours back.

Tell us the job you cannot keep staffed.

Twenty minutes, no deck. Name it and we will work one in front of you, live, on a test account.

Central Get your hours back.

Tell us the job you cannot keep staffed.

Twenty minutes, no deck. Name it and we will work one in front of you, live, on a test account.