Prior Authorization Automation: Cut Approval Times from 10 Days to 2 Hours
The Prior Auth (PA) agent identifies requirements from eligibility checks, automatically extracts supporting evidence from clinical documentation, and submits PA packages via electronic payer portals or FHIR APIs.
Why Prior Authorization Automation Matters
Manual prior authorization costs $11 per transaction and delays patient care for 92% of medical practices.
The Problem
Physician practices spend up to 14 hours per week per physician navigating manual prior authorization requirements. Payers frequently modify clinical documentation rules, leading to unexpected treatment delays and administrative friction.
How Medsynthea Solves It
The Prior Auth (PA) agent identifies requirements from eligibility checks, automatically extracts supporting evidence from clinical documentation, and submits PA packages via electronic payer portals or FHIR APIs.
Which Agents Power Prior Authorization Automation
Coordinated parallel agents executing this solution.
Eligibility Agent
Verifies Real-Time Insurance Eligibility in Under 2 Seconds
Documentation Agent
Transcribes Clinical Encounters and Reduces Charting Time by 70%
Prior Auth Agent
Automates Prior Authorization Submission and Reduces Turnaround by 60%
FAQs — Prior Authorization Automation
How does Medsynthea handle prior authorization automation?
Medsynthea's PA agent extracts prior authorization requirements during real-time eligibility verification, assembles required clinical documentation from encounter notes, and submits requests directly through electronic payer portals or FHIR APIs in minutes.
What results can practices expect with Medsynthea's Prior Authorization Automation?
60% faster turnaround time and 91% initial prior auth approval rate
Transform Your RCM with Prior Authorization Automation
Schedule a personalized walkthrough with our revenue cycle engineers.