Prior auth, automated: from days to minutes
Automated prior authorization pulls the clinical evidence, fills the forms, and submits — in minutes.
Prior authorization is where practice time goes to die: staff on hold, forms that ask for the same information in different orders, and a chart-diving exercise for every request. The medicine is usually not in question — the friction is administrative.
What automation actually does
The evidence for an authorization already lives in the chart: the diagnosis, the failed conservative therapy, the exam findings, the imaging report. Automated prior auth assembles that evidence — pulling the relevant problems, medications, and notes into a structured medical-necessity package — and prepares the request for review and signature.
The clinician still signs. That is both a safety property and a legal one: the request that goes out is one a human reviewed, with the evidence attached and legible.
An honest status report
Two claims deserve care here. First: assembling the request is the part that automation does well today, and it is the part that consumes staff hours. Second: how the request reaches the payer still varies — some payers accept electronic submission, many still require portals or fax, and the industry's electronic standards are arriving payer by payer. Automation that is honest about that boundary — including telling you when the evidence is insufficient rather than papering over it — is worth more than automation that promises magic.
Even within those limits, the difference is stark: a request that took a staff member forty minutes of assembly becomes a review-and-sign task measured in minutes, with a status board instead of a sticky note.