Agentic Intelligence for Prior Authorization
Curious about Steve's capabilities?
Coverage Verification
Steve checks patient's insurance details and verifies if the requested service requires prior authorization based on the payer's rules and the patient's plan.
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Documentation Review
Steve automatically reviews all clinical documents, ensuring required records, medical necessity justification, and correct diagnosis/procedure codes are present for the authorization request.
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Authorization Submission
Steve submits the pre-authorization request with all necessary documentation to the payer. If any information is missing, Steve automatically drafts emails to request it from the referring facility.
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Status Monitoring
Steve tracks the authorization status and immediately notifies the team of approvals or denials. For denials, Steve provides detailed reasons and assists with resubmission or appeals process.
Next-Gen Pre-Auth: Streamlining Care Authorization
Automated prior authorization via direct payer calls, handling complex approval workflows and clinical requirements
Parallel submission across payer portals, phone systems, and fax with unified tracking
Dynamic adaptation to payer-specific requirements with automated clinical documentation matching
Self-improving denial management with automated evidence collection and appeal generation
Automated extraction and mapping of clinical evidence to authorization requirements
Sub-second synchronization across all payer channels with unified status tracking
Proactive validation of clinical documentation against payer requirements before submission
End-to-end encryption and secure PHI management
85% reduction in manual authorization time with automated submission
>95% first-pass authorization success rate through intelligent validation
Seamless handling from 10 to 10,000+ monthly authorizations
Real-time dashboard tracking verification success rates, processing times, and cost savings
