RISA GOLD

Remove prior authorization with confidence. Built with New York’s best oncologists.
Designed to get every patient on the right evidence-based therapy, faster.

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RISA acts as the neutral trust layer between payer and provider, delivering utilization audits of gold carded oncologists. 

Problem

Leading community oncologist, New York

"We want to eliminate prior authorization, not just streamline it. We spoke with a NY payer who already approves over 95% of our requests. Both sides lose time, money, and patient trust in the process.

Together, we want a shared mechanism for transparent audits so that prior authorization can safely be removed. RISA Gold provides that neutral trust layer, delivering clarity and confidence to both payer and provider.”

What Is Gold Carding, and Why It Doesn’t Work (Yet)

Gold carding was designed to reward trusted physicians. Gold card status allows clinicians to skip prior auth for specific procedures, drugs, or tests, reducing paperwork and accelerating care.In practice, it rarely works as intended.
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Strict approval thresholds, inconsistent implementation, annual wait time for status reviews, and the lack of a shared audit mechanism, As a result, most pilots start strong, then stall as payers lose visibility and providers lose trust.

How RISA Gold Is Different

RISA Gold closes the audit gap that makes traditional gold card programs unworkable. RISA doesn’t bypass prior authorization — it replaces it with continuous, transparent auditing that gives both sides confidence to eliminate unnecessary paperwork

Audit-first design

Every case is logged, verified, and benchmarked.

Evidence-based automation

Appropriateness rules mirror payer guidelines, enabling oversight without manual review.

Oncology-specific

Focuses on high-volume, low-denial oncology codes where data clarity and safety margins are highest.

Our Goal

Prove that for a focused set of oncology services, prior authorization can be eliminated without losing safety, quality, or cost control.
Join a study.

What Success Looks Like

Clinical & Operational Metrics
Business & Quality Metrics

≥98% of audited cases meet prior auth criteria without manual review.

Average time from request to treatment start reduced by at least 50%.

No patient safety issues or inappropriate utilization events reported.

Provider admin time per case drops by 70%+, freeing staff for clinical tasks.

For payers, STAR-linked metrics improve, including:

  • Timely access to cancer treatment
  • Patient experience scores
  • Care coordination ratings

RISA’s impact with current customers

97.4%

1st submission success rate: 97.4%

400+

Total providers

5×

Reduced turnaround times

Your questions answered

Is this a replacement for prior authorization?
Not entirely. RISA automates medical necessity checks and audits every case post-care, ensuring oversight remains intact while removing friction.
How is RISA involved day-to-day?
RISA connects via light-touch integration (portal, API) to capture data, verify compliance, and generate shared audit dashboards.
Who qualifies to join the pilot?
Oncology practices with high prior-auth approval rates (>90%) and payers seeking faster turnaround and measurable STAR metric improvements.
How long is the study?
A 90-day pilot, followed by an outcomes report and optional subscription for continuous audit and scaling.
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