Prior Authorizations
Automated triage for faster clearance and smoother care
A provider makes the clinical decision and sets the treatment plan. Then the paperwork begins, checking payer requirements, gathering documentation, submitting requests, and repeatedly tracking their status. What should be routine administration can quickly become a costly operational bottleneck.
IntellusMD simplifies prior authorizations from start to finish through an intelligently designed agent that identifies when authorization is required, assembles supporting documentation, submits requests through the appropriate channel, and tracks each case through to a final decision.
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Know Before You Submit
Certainty, before the clock starts.
The most frustrating part of prior authorization is often not knowing, spending time verifying requirements, interpreting payer rules, and figuring out whether a request is even needed before anything can move forward.
This AI agent auto-detects when a procedure or prescription triggers an authorization requirement, removing the guesswork so your staff spends time only on requests that actually need it.
The sooner requirements are known, the sooner the clock starts running the right way.
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Collect What Counts
Approvals run on evidence, not effort.
A prior authorization request is only as strong as what backs it up. Missing records, thin clinical detail, incomplete documentation, these are what stall requests and delay patients.
Our AI prior authorization service assembles payer-specific clinical evidence packets automatically, so requests arrive complete, and payers see exactly what they're expecting to see.
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Navigate Payer Requirements
One process for every payer, however many they run.
Every payer has its own submission method, its own requirements, its own workflow, and healthcare organizations are expected to track all of them at once.
IntellusMD's AI agent submits each request through the correct channel for that payer, portal, fax, or payer API, replacing a patchwork of manual tracking with one consistent process.
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Follow Through, Stay Ahead
Submission is the start, not the finish.
Most requests still need status checks, added documentation, or ongoing payer communication before a decision is reached, and that follow-up is often the most time-consuming part of the entire process.
We monitor requests after submission with automated status tracking and follow-up, so no one on staff has to chase a request manually from start to finish. Proactive alerts flag auths that are expiring or denied, so nothing slips through unnoticed.
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Keep the Team Aligned
Transparency removes the guesswork.
Authorization delays create communication gaps, and those gaps are where patient trust and staff patience both wear thin.
Our AI agent brings visibility to the entire process, keeping your organization current on authorization progress and helping ensure patients get timely updates on where their request stands.
Clear communication is what makes a slow process feel like a managed one.
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When a Denial Comes Back
A denial isn't the end of the request, just the next step in it.
Denials happen, even with a complete submission. When they do, waiting on a busy staff member to draft an appeal from scratch only adds more delay to care that's already been decided on clinically.
This agent supports appeal drafting for denied requests, helping staff respond faster with the documentation and context already assembled from the original submission.
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Reduce Administrative Burden
Let clinical teams do clinical work.
Prior authorizations are necessary. The hours they consume don't have to be.
By handling detection, documentation, submission, tracking, and follow-up, this agent strips out the manual work behind every request, so staff spend less time on process and more time on patients and providers.
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From Request to Decision
One workflow. Every step accounted for.
This agent connects detection, documentation, submission, tracking, and follow-up into a single continuous workflow. The requirement is detected. The evidence packet is assembled. The authorization is submitted. Progress is tracked. The decision comes back, and if it's a denial, the appeal is ready to go.
What used to mean juggling dozens of disconnected tasks becomes one clear path to completion.
Capabilities
What it does
Everything you need from Prior Authorizations, working out of the box and tuned to your practice.
- Auto-detects when a procedure or prescription needs authorization
- Assembles payer-specific clinical evidence packets
- Submits through the correct channel — portal, fax, or payer API
- Automated status tracking and follow-up after submission
- Proactive alerts for expiring or denied auths
- Appeal drafting support for denied requests
- Visibility for staff and timely updates for patients
Move faster toward care
Prior authorization should support the care a provider has already decided on, not stand in front of it.
Common questions
Does it work across payers?
Yes. Every payer has its own submission method, requirements, and workflow. IntellusMD submits each request through the correct channel for that payer — portal, fax, or payer API — replacing a patchwork of manual tracking with one consistent process.
What about denials?
Denials happen, even with a complete submission. The agent supports appeal drafting for denied requests, helping staff respond faster with the documentation and context already assembled from the original submission.