Supervised AI agents for prior authorization.
Staff toggle between the EHR, payer portals, and status screens to submit and chase authorizations. The clinical decision takes minutes; the portal work takes the hour.
Where the time goes
Every payer portal has its own login, navigation, and request forms, so staff re-learn each one. Member IDs, CPT and ICD codes, and clinical documentation are re-keyed from the EHR into portal forms. Status checks repeat daily across the whole worklist, one case and one portal at a time.
What the agent takes on.
Opens the payer portal and starts a new authorization request for the case Enters member, provider, and CPT/ICD details pulled from your systems at the step level Attaches the clinical documentation package and submits after review Records the confirmation number and writes it back to your tracking system Runs daily status sweeps across the worklist and updates each case
Where clinicians stay in the loop
A clinician reviews the documentation package before the agent submits Pend-for-information and denial responses route to a nurse for a decision Every submission and status check lands in the audit trail