AI Agent

Prior Authorization AI Agent

Get authorizations in hours instead of days

Manual prior auth takes 3+ days and delays patient care. AI completes authorizations in hours with 75% approval rate improvement.

Benefits

Stop Losing Patients to Prior Auth Delays

Manual prior authorization takes 3+ days per request delaying patient care and causing appointment cancellations. Incomplete submissions create denials requiring rework. Staff can't track status across multiple payers. This agent completes authorizations in hours with higher approval rates.

75%

Faster approvals

Same-day

Request submission

40%

Denial reduction

Agentic Flows

Complete Prior Auth Automation

Automated workflow: payer requirement determination by CPT code, clinical documentation collection and validation, electronic request submission to payers, status tracking with automated follow-up, denial management with appeals, authorization integration to scheduling and billing.

How it works

Intelligent Prior Authorization Management

The agent determines authorization requirements by payer and procedure automatically, gathers clinical documentation and submits complete requests electronically, tracks authorization status with proactive follow-up and escalation, handles denials with peer-to-peer coordination and appeals.

Self-Learning Agents

The agent improves with every task, adapting to outcomes, applying feedback, and self-correcting using Constitutional AI.

Upto 98% Accuracy

As a result of constant feedback loops, Beam AI Agents refine their approach with every cycle, leading to 98% accuracy across flows.

Smart Model Switching

We call it ModelMesh. Each agent selects the right model for the task, balancing speed, accuracy, and cost in real time.

Extract order number, seller information, delivery information, and payment details from the uploaded order forms.

Completed

ID-0E48

Extract order number, seller information, delivery information, and payment details from the uploaded order forms.

Completed

ID-0E48

Extract order number, seller information, delivery information, and payment details from the uploaded order forms.

Completed

ID-0E48

Self-Learning Agents

The agent improves with every task, adapting to outcomes, applying feedback, and self-correcting using Constitutional AI.

Upto 98% Accuracy

As a result of constant feedback loops, Beam AI Agents refine their approach with every cycle, leading to 98% accuracy across flows.

Smart Model Switching

We call it ModelMesh. Each agent selects the right model for the task, balancing speed, accuracy, and cost in real time.

Extract order number, seller information, delivery information, and payment details from the uploaded order forms.

Completed

ID-0E48

Extract order number, seller information, delivery information, and payment details from the uploaded order forms.

Completed

ID-0E48

Extract order number, seller information, delivery information, and payment details from the uploaded order forms.

Completed

ID-0E48

Integrations

Works with Healthcare Systems

Direct integration with Epic, Cerner, athenahealth EHRs for orders and documentation. Connects to CoverMyMeds, Surescripts, and payer portals for authorization submission. Real-time eligibility verification via Change Healthcare and Availity.

Implementation

Authorizing Faster in 2 Weeks

Connect your EHR, scheduling, and payer systems. Configure authorization rules by payer and procedure. Most practices get same-day authorizations within 14 days of deployment.

Step 1

Agent Discovery

Conduct workshop(s) with relevant stakeholders to identify and prioritize use cases and map the requirements

Step 1

Agent Discovery

Conduct workshop(s) with relevant stakeholders to identify and prioritize use cases and map the requirements

Step 2

Agent Setup

Develop and launch your first agent with basic logic and integration (process scoping and recording, test dataset of 30-50 examples, baseline agent running and testing with target output mapping)

Step 2

Agent Setup

Develop and launch your first agent with basic logic and integration (process scoping and recording, test dataset of 30-50 examples, baseline agent running and testing with target output mapping)

Step 3

Agent Training

Test performance and gather feedback from process users (agent optimization up to 80% against expected output, variable-level accuracy measurement and optimization, integrations setup, and feedback API interfacing)

Step 3

Agent Training

Test performance and gather feedback from process users (agent optimization up to 80% against expected output, variable-level accuracy measurement and optimization, integrations setup, and feedback API interfacing)

Step 4

Agent Live

Extend to more workflows and client teams (live and continuous monitoring, human-in-the loop interfacing, node auto-tuning for automated prompt enhancements, >90% accuracy improvement, weekly business logic improvements)

Step 4

Agent Live

Extend to more workflows and client teams (live and continuous monitoring, human-in-the loop interfacing, node auto-tuning for automated prompt enhancements, >90% accuracy improvement, weekly business logic improvements)

Key Features

Prior Auth Features

Auto Requirement Detection

Determines if prior auth is required automatically. Checks payer policies by procedure and diagnosis.

Complete Submissions

Gathers all required clinical documentation. Submits complete requests that maximize approval rate.

Proactive Status Tracking

Tracks authorization status with payers. Follows up automatically and escalates delays before appointments.

Demo

See Prior Authorization in Action

Watch the agent process 50 prior auth requests: determine requirements, gather documentation, submit electronically, track status, obtain 48 approvals—all in 4 hours.