Prior Authorization Agent
Drafts, submits, and follows up on prior-auth requests across payer portals — without a human in the form.
RCMBrowser-usePayerMulti-step Live demo available
Prior Authorization Agent
Polished agent demo — preview
Agent running
Agent thinking
- 1Reading inputs and pulling relevant context across systems…
- 2Building a plan: 4 steps, 2 tools, 1 human approval gate.
- 3Executing steps with progress streaming back to the user.
- 4Decision made. Drafting summary and queuing for review.
The problem
Prior auth is the #1 administrative burden cited by physicians. Each request takes 20–45 minutes of staff time and rejections stall care for days.
What the agent does
- Reads the clinical note, identifies the requested service, and finds the matching payer policy
- Assembles the form, attaches relevant labs/notes, and submits via portal or fax-to-API
- Polls for status, responds to peer-review requests, and notifies the care team on decision
Business value
Reduces prior-auth labor by 80% and shortens average approval time from 4.2 days to under 24 hours.
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