Prior Authorization
An agent reads the chart and payer policy, assembles the documentation, verifies benefits, and submits the request, routing only true exceptions to a reviewer.
We deploy agents that read the chart, check the policy, and take the action inside the EHR and payer systems, from prior authorization to claims to care coordination. Every decision is grounded in clinical evidence, routed to a clinician when judgment is required, and fully auditable.
An agent reads the chart and payer policy, assembles the documentation, verifies benefits, and submits the request, routing only true exceptions to a reviewer.
An agent watches charge capture and coding across the EHR, validates claims before they go out, and works the queue so claims submit clean the first time.
An agent reads the denial codes, finds the root-cause pattern, pulls the corrective clinical and billing evidence, and drafts and files the appeal end to end.
An agent listens to the visit, generates the structured note and suggested codes, and files it into the EHR for the clinician to sign, with no manual typing.
An agent scans EHR and claims data for care gaps and rising-risk patients, then schedules outreach and coordinates interventions across the care team.
An agent reasons over streaming device and vitals data, triages the alerts, and escalates clinically urgent cases to a nurse in minutes instead of days.
up to 90% automated
The agent now automates up to 90 percent of prior authorization requests and reaches roughly 85 percent real-time approval, with submissions filed clean on the first pass.
A regional multi-specialty medical groupdenials down ~30%
Denials fell around 30 percent and net revenue rose near 20 percent within two quarters of putting the agent on the queue.
A nonprofit community hospital system2-3 clinician hours/day back
Clinicians reclaimed 2 to 3 hours a day from documentation and administrative burden dropped near 30 percent, with notes closing the same day instead of days later.
A multi-site primary care networkA first conversation covers the problem you want solved, whether AI fits it, and a sensible next step. You do not need an engineering team in place.