Prior Authorization Agent
Approve faster. Treat sooner. Reduce friction.The Prior Authorization Agent navigates the complex web of payer rules and portals for you—ensuring every procedure is cleared before the patient arrives, eliminating the administrative burden that stalls care delivery and costs your team thousands of hours per year.
What It Does
Every authorization submitted, tracked, and secured with AI precision
Automated Requirement Detection
Instantly identifies if a prior authorization is required based on specific CPT codes and payer-specific rules.
Intelligent Submission Workflows
Automatically prepares and submits complete, compliant authorization requests, including all necessary clinical attachments.
Status Tracking
Accesses and monitors payer portals for approvals, denials, or requests for more information, updating your system instantly.
Clinical Documentation Management
Ensures all required medical necessity documentation is aligned and included to prevent avoidable missing info delays.
Dynamic Payer Logic
Adapts in real time to the changing UI and submission requirements of different insurance portals—never brittle, always current.
Proactive Alerts
Automatically notifies your clinical team of approvals, expiring authorizations, or cases that require human intervention.
Built for High-Volume Environments
Care should never be delayed by a checkbox
Hospitals & Health Systems
Manage complex authorizations across multiple departments and payers.
Specialty Care (Oncology, Cardiology)
Secure fast-tracked approvals for time-sensitive, high-cost treatments.
Surgical Centers
Ensure every case is financially cleared before the patient enters the OR.
RCM & Operations Teams
Scale your authorization capacity without adding a single headcount.
Measurable Impact
Automated authorizations protect clinical outcomes—not just operational efficiency
Accelerated Treatment Timelines
Drastically reduce patient wait times by securing approvals in hours or days, not weeks—so care is never held hostage to paperwork.
Eliminate Auth-Related Denials
Ensure every claim has a valid, matching authorization number before it is even billed.
Drastic Reduction in Staff Burnout
Free your high-value clinical staff from portal fatigue by automating the repetitive data entry and status checking.
Enhanced Patient Trust
Provide a smoother experience where patients feel their care is the priority, not the paperwork.
Why Traditional Authorization Management Falls Short
Most manual processes or standard RPA tools:
Are brittle and break the moment a payer updates their website layout
Lack the clinical intelligence to know which documents satisfy medical necessity
Require staff to maintain 50+ portal passwords and manually log in to check status
Create a black hole of information between the front office and the clinical team
The Prior Authorization Agent goes deeper—combining flexible browser automation with contextual understanding to ensure care is never delayed by a checkbox.
How It Works
From procedure order to approved authorization in four automated steps
Ingest Order Data
Pulls procedure orders and patient demographics directly from your EHR or scheduling system the moment an order is placed.
Verify and Prepare
Determines auth necessity and gathers the specific clinical data required by that specific payer—no guesswork.
Submit via Browser Agent
Logs into the payer portal exactly like a human would, navigating forms and uploading documents with 100% accuracy.
Track to Completion
Checks back on a scheduled loop until an authorization number is secured and written back to your system automatically.