AI checks requirements, prepares clinical documentation, submits requests and tracks payer status.
Prior authorization is spread across the EHR, payer portals, clinical notes, fax queues, and phone calls. Prior Auth AI replaces that scramble with one guided workflow.
Order → requirement check → clinical documentation → submission → status tracking → determination, with human review whenever something is missing.
Walk through a live prior authorization example with our team — no obligation.
Prior Auth AI works the request the way an experienced authorization specialist would — and tells your team exactly what it checked, what it found, and what still needs attention.
Prior Auth AI sits between the systems your staff already use and the channels your payers already accept — no rip-and-replace.
Prior Auth AI is built to take repetitive work off your team so authorizations move forward without constant manual follow-up.
Cut the portal logins, re-keying, and follow-up calls that consume authorization coordinators’ days.
Requests are prepared and submitted as soon as the order is placed instead of waiting in a queue.
Documentation gaps surface before submission, reducing avoidable payer pends and denials.
Every authorization, stage, and aging day is visible to the whole team in one shared dashboard.
Authorization coordinators, RCM leads, and practice administrators on what changed once Prior Auth AI started working the queue. Shared anonymously at our clients’ request.
We used to sit on hold just to find out whether a study even needed authorization. That check happens before the order leaves the department now, so the day starts with a work list instead of a phone queue.
The part that actually changed our week is the missing-document flag. We find out something is short before it goes to the payer, not a week later when the request comes back pended.
Everyone used to keep their own spreadsheet, so nobody could answer where a request stood without asking three people. Having one shared view of every authorization ended most of those conversations.
Tell us a little about your organization. We’ll show how HiPaaS Prior Auth AI can support your current authorization process.
HiPaaS Prior Auth AI helps healthcare teams run prior authorization end to end — checking whether an order needs authorization, assembling the supporting clinical documentation, submitting the request to the payer, and tracking status until a determination is returned.
Prior Auth AI is designed to work with electronic prior authorization workflows including X12 278 request and response transactions, FHIR-based prior authorization APIs such as PAS, CRD, and DTR, and payer portal and API submission paths.
When required documentation is missing or incomplete, Prior Auth AI flags the specific gap, shows what the payer expects, and routes the request to a staff member for human review instead of submitting an incomplete authorization request.
No. Prior Auth AI handles the repetitive preparation, submission, and follow-up work, while clinical and authorization decisions stay with your staff and the payer. Human review points are built into the workflow.
It is designed to work alongside your existing EHR, practice management, and scheduling systems, and to reach payers through FHIR APIs, X12 transactions, and payer API portals.
It is designed for medical practices, specialty clinics, imaging and surgical groups, health systems, RCM teams, and medical billing organizations that manage a high volume of prior authorization requests.
Prior Auth AI Agent