Custom AI automations designed for the daily challenges prior authorization specialists face. Stop doing manually what AI can handle.
AI drafts post-visit instructions from the encounter, sends them to the patient, places orders in CoverMyMeds, and schedules the next visit — the care plan actually happens.
AI assembles the CAQH profile, submits payer applications, tracks each status, and escalates stalls — time-to-enrolled drops from 120 days to 60.
AI sends post-visit surveys, flags detractors for same-day outreach, and routes promoters to review sites — reputation and clinical quality move in the same direction.
AI triages each denial by root cause, recovery likelihood, and appeal deadline — the team works the right denials first and the aged ones don't die quietly.
AI runs PDMP checks on every controlled-substance order, documents the check in CoverMyMeds, flags concerning patterns, and generates compliance reports — audit-ready, every prescription.
AI schedules infusions against chair capacity in CoverMyMeds, verifies drug stock and PA, and rebalances when patients reschedule — chair utilization climbs and patients stop waiting.
AI checks payer-specific PA requirements, pulls the chart from CoverMyMeds, submits the PA with clinical justification, and tracks status — turnaround drops from 7 days to under 48 hours.
AI classifies denials by reason code, drafts the appeal letter with chart-cited clinical support, resubmits with corrected info, and tracks the payer response — appeal capture rate doubles.
These are just examples. If you're a prior authorization specialist with a repetitive process that's eating your time, we can probably automate it.
