Optyzone

Prior Authorization Agent

Drafts, submits, and follows up on prior-auth requests across payer portals — without a human in the form.

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Prior Authorization Agent
Polished agent demo — preview
Agent running
Agent thinking
  1. 1Reading inputs and pulling relevant context across systems…
  2. 2Building a plan: 4 steps, 2 tools, 1 human approval gate.
  3. 3Executing steps with progress streaming back to the user.
  4. 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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