Built for independent specialists
CAL is built for independent specialists: the approval path, and what it will cost the patient, before the patient leaves the room. The plan for the next thirty days is what we are building next.
The problem
The decision is made in the visit. The approvals, prices and next steps are settled somewhere else — after it.
a week spent on prior authorization by physicians and their staff.
1 2025 AMA Prior Authorization Physician Survey
of physicians report patients abandon treatment due to authorization challenges.
1 2025 AMA Prior Authorization Physician Survey
1 Cited source, with its date. Figures are the survey's, not ours.
The four questions
What the clinician and the patient settle together, in the room, instead of over the following weeks.
The options ranked for this patient, with the reasoning attached.
The approval path, with the payer context already in the room.
The patient's cost, before they leave rather than weeks later.
What happens next, who does it, and what the patient should expect.
Where it sits
Built for independent specialist practices, at the point of care.
| Point solutions | Enterprise platforms | CAL | |
|---|---|---|---|
| Built for | One task (for example, prior auth only) | Health systems and large IT teams | Independent specialist practices |
| Where it works | Back office, after the visit | Across the enterprise, configured centrally | At the point of care, in the exam room |
| Scope | Single workflow | Broad, generic | Pharmacy, scheduling, referrals, prior authorization, follow-up |
| Who holds authority | Payer rules and staff queues | Enterprise policy | The clinician verifies and authorizes every decision |
| Data | Task-level | System-wide, specialty-generic | Specialty, patient, practice and payer context, governed by specialists |
Fits your practice
One workflow first, measured, then the next.
Designed for the iPad. It runs in the browser and installs to the home screen — not a native app yet.
Your records system stays where it is. Direct EHR connections are on the roadmap.
One platform
A layer that sits alongside your records system and restores the clinician's line of sight across the visit.
What the patient can actually get, and what it costs them.
Follow-up that happens, and lands in the right slot.
Hand-offs that carry the context with them.
Lighter follow-up, with the plan already agreed.
The approval path known before the visit ends. This is the workflow being brought into practices first.
How the layer works
A patient walks into the clinic room, then CAL begins assembling answers. Four steps, in the clinic, in order — and the clinician remains the final authority.
The clinician accesses patient care, and the layer interprets the assessment.
The layer organizes, gathers, and distills patient information and presents the patient record.
The rules the clinician approved rank the options, with the reasoning and the payer rules attached. The clinician decides.
Clinician and the layer execute the care plan. Staff prepare the authorization, the cost and the follow-up; nothing releases until the clinician verifies and authorizes.
Prior authorization is the first workflow built on the layer. The other steps describe how the layer is designed to run, not what is in front of a clinician today.
The flywheel
Evidence — the specialty's own guidance, adjudicated by its clinicians.
Tools — built for independent specialists.
Workflows — the visit as it runs, not a queue after it.
More specific to the specialty and to the practice — not a generic system with a specialty skin.
Clinical governance
A board chair, a chief medical officer and the specialty's own clinicians adjudicate the clinical content the layer ships. The clinician in the room remains the final authority on the patient in front of them.
Who it serves
Your patients, your judgment, your decision. Brought into one workflow at a time.
One point-of-care decision path across every location, under governed clinical content.
Both start the same way: one working session with a founder, mapped against the workflow that costs you the most.
Book a working sessionAbout
CAL's tools, workflows and agents answer to an evidence corpus — every recommendation traces to guidance the specialty's own clinicians adjudicate — so a clinician and a patient can answer four questions inside the visit: what is the care plan, will it be approved, what will it cost, and what happens next.
CEO & co-founder
Jonas Varnum is CEO and co-founder of the Clinical Authority Layer. He spent fifteen years building healthcare delivery companies as a management consultant, leading consulting, products and transformation work across health-tech and provider systems, and is a certified Chief AI Officer (University of Chicago Booth).
CAIO & Head of Architecture
Lori Rainery is CAL's CAIO and Head of Architecture. She has spent more than twenty-five years in enterprise AI and enterprise architecture, including at Everbridge, a Thoma Bravo portfolio company, and before that as an Enterprise Architect at Zix/Appriver. She is a certified Chief AI Officer (University of Chicago Booth). At CAL she leads the architecture behind the layer — the evidence corpus, the review gates every recommendation passes through, and the record of who signed it. She also leads the Phoenix chapter of Women AI Builders, an initiative of the WomenTech Network.
Founder & Chairman
Biography to come.
Chief Medical Officer
Dr. Kenna Belshe is a board-certified internist and practicing hospitalist with a deep commitment to advancing healthcare quality and driving meaningful, system-wide improvements in patient care.
Prior to joining CAL, Dr. Belshe served as Chief Clinical Officer at NKC Health, where she led quality and performance improvement initiatives. She also served as Board Chair of Centrus Health KC, a clinically integrated network serving the Kansas City region. Throughout her career, she has demonstrated a passion for improving healthcare delivery, strengthening clinical outcomes, and advancing quality initiatives at scale.
Dr. Belshe completed her internal medicine residency at the University of Missouri–Kansas City after earning her medical degree from Kansas City University of Medicine and Biosciences.
She is actively involved in several professional and community organizations, including the American Case Management Association, American College of Physicians, American College of Physician Advisors, Association of Physician Leadership in Case Management, Kansas City Southwest Clinical Society, Kansas City Medical Society, and National Association for Healthcare Quality.
Chief Engineer, Product Leader
Biography to come.
A board chair, a chief medical officer and the specialty's own clinicians adjudicate the clinical content the layer ships.
The content that ships will carry that sign-off, and the clinician in the room still makes the call.
Start a conversation
Tell us where the visit slows down. A founder will meet with you to map one workflow in your practice — no commitment, and no pitch deck.
Prefer email? hello@theclinicalauthoritylayer.com
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A founder will meet with you to map one workflow in your practice.
Privacy
Last updated 5 November 2026
Your name, work email, company, role, engagement interest and message. Nothing else.
To reply to you and set up the working session you asked for. That is the only use.
To CAL's own systems — the inbox we read, and the service that delivers the form to it. It is not added to a mailing list.
If the conversation goes nowhere, we delete it within twelve months. If we go on working together, we keep it while that lasts, and delete it afterwards.
This site sets no cookies and runs no advertising or analytics trackers. It loads nothing from a third-party server, so there is no cookie banner — there is nothing to consent to.
The form is for practice and business enquiries. Do not put patient details, records or identifiers in the message field.
Email hello@theclinicalauthoritylayer.com and ask. We will delete what we hold and confirm that we have.
Questions about this notice go to the same address: hello@theclinicalauthoritylayer.com.
Still to be built
Nothing here pretends a page exists. This panel replaces the nine dead links the old navigation pointed at.
The layer workflow by workflow, with its architecture and its status.
How the clinical content is made, who adjudicates it, and what the record shows.
Where data sits, who can see it, and what agreements are in place.
A scheduling page. The form above is the interim route, and it is not wired yet.
The privacy notice is written and sits above. A terms page and an accessibility statement do not exist yet.