AI agents that end prior-authorization hell.
Prior authorization automation, in production: prior auth burns clinician hours and delays care. We build a production agent that fills the payer form, attaches the evidence, and appeals the denial — so your staff get back to patients.
What the agent actually does.
A production agent that fills the form, attaches the evidence, and appeals the denial — around the clock.
How the agent runs
From requirement detection to a won appeal — fully instrumented.
Proven, not promised
Tracked against payer outcomes, not promises.
first-pass approval, post-deploy
Reads every source
Pulls clinical evidence and maps it to payer rules.
Structures the data
Maps the chart to medical-necessity criteria automatically.
Decides with evidence
Every submission tied to the payer's own criteria.
AI prior authorization turns pure administrative waste into recovered time.
Nurses and physicians chase payer forms and re-submit denials instead of treating patients. The work is rules-driven and repetitive — exactly what an agent does well, around the clock.
When the paperwork runs itself, your clinicians get their time back.
Today, every authorization competes with patient care for staff hours — and care usually loses. The agent runs each submission end to end and escalates only the genuine exceptions. Approvals come faster, fewer therapies are abandoned, and the queue stops outrunning your team.
- Clinical staff stop drowning in payer paperwork
- Faster approvals mean fewer delayed or abandoned therapies
- Higher first-pass approval and appeal overturn rates
- Every submission mapped to payer medical-necessity criteria
Prior auth is pure administrative waste with massive emotional pain — automating it returns clinician time to patients and recovers revenue lost to abandoned treatments.
Common questions, answered.
Can AI really handle prior authorization?
Yes. Detecting the requirement, completing the correct payer form, attaching evidence mapped to medical-necessity criteria, and appealing denials are document-and-rules tasks an AI agent performs at scale, 24/7.
Who is this for?
Specialty clinics and hospital systems where prior-auth volume is high and clinical staff are stretched — anywhere the paperwork is delaying care and burning out staff.
Does it integrate with the EHR?
The agent pulls the relevant clinical evidence and submits through payer channels; integration is part of a scoped implementation so it fits the systems and workflows you already use.
How does it handle denials?
It drafts evidence-backed appeals that cite the payer's own medical-necessity criteria, which lifts overturn rates and recovers revenue otherwise lost to abandoned therapies.
Go deeper: How AI Prior Authorization Ends the $30B Paperwork Crisis
Why prior auth wastes $30B a year, how an agent fills forms and appeals denials at scale, and what to expect from a production deployment.
Ask about the 2-week auditTell us if AI prior authorization is worth owning.
In a two-week audit we map your prior-auth volume, the clinician hours it consumes, and exactly where an agent pays for itself. You get back a build plan, not a pitch.