✅ AI autopilot · prior-auth

Prior-authorization autopilot

Turns a prior-auth request + chart into an approval or a clean determination — a medical director signs every denial.

Payer UM lead / provider revenue leadbuys it $35–56Bmarket 5 auto · 1 humanflow steps

The problem

Prior authorization is the most-hated administrative burden in US healthcare — slow, manual, and a denial without a physician signature is a legal and reputational landmine.

What you get

Routine requests are auto-approved against criteria in minutes; only genuine medical-necessity calls reach a medical director, who signs every adverse determination.

The flow

Intake to outcome. 🤖 steps run automatically; 🧑‍⚖️ steps are where a named human signs off the judgment calls.

  1. 1
    🤖 Pull the auth request and clinical chart from the EHR
    agent intake · EHR (FHIR)Document OCR
  2. 2
    🤖 Match the request against medical-necessity criteria (MCG / InterQual / NCD-LCD)
    agent reviewer · Medical-necessity criteriaPayer rules / LCD-NCD
  3. 3
    🤖 Run gold-card, ERISA-plan and appeal-rights checks; draft the determination
    agent compliance · Payer rules / LCD-NCD
  4. 4
    🧑‍⚖️ A plan medical director signs every denial / adverse determination Human checkpoint
    Plan medical director (MD)
  5. 5
    🤖 Transmit the determination to the provider via the X12 278 / FHIR portal ⚠ Irreversible · high blast
    agent submit · Prior-auth portal (X12 278)
  6. 6
    🤖 Track turnaround SLAs and route appeals
    agent monitor · Prior-auth portal (X12 278)

Agents & tools

  • EHR (FHIR) ● live · Epic
  • Document OCR stub → AWS Textract
  • Medical-necessity criteria ● live · MCG
  • Payer rules / LCD-NCD stub → CMS coverage DB
  • Prior-auth portal (X12 278) stub → Availity

2 of these run live on real data — keyless by default; the rest are sandbox stubs that flip to the real provider the moment you add credentials.

Human checkpoints

  • Plan medical director (MD) — A plan medical director signs every denial / adverse determination

The autopilot escalates the judgment calls to a qualified human — the rest is straight-through.

Why it's safe to let it run

Every autonomous decision is logged — who · what · confidence. Signed human checkpoints and a built-in compliance reviewer enforce the rails, so the outcome holds up to an audit, not just a demo. Every irreversible action runs only after a human signs — the autopilot does the volume, never the point of no return on its own.

🧑 Accountable owner: Plan medical director (UM) — one person answers for what this autopilot does.

Related autopilots

Same buyer, adjacent function — the connectors and compliance packs are shared.

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