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We don't just build software. We deliver results. EXPLORE NOW!
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We turn ideas into scalable products with proven delivery across 18+ industries. EXPLORE NOW!

Prior Authorization: 6 Days to Under 24 Hours

An AI agent that submits, tracks, and resolves prior authorizations autonomously.

Automate Your Prior Authorizations

About the Project

A prior authorization agent inside the EHR: reads orders and notes, assembles payer packets, resolves in under 24 hours.

Industry

Healthcare / Multi-Specialty Medical Group

Imaging, specialty medications, and outpatient procedures across many payer mixes.

  • Multi-Specialty
  • Advanced Imaging
  • Outpatient Procedures
Business Type

Provider Group — 9 Locations

One authorization team serving nine sites and dozens of payer portals.

  • Provider Group
  • 9 Locations
  • Central Auth Team
Core Offering

AI Prior Authorization Agent (Bonami X AI)

Reads the order, assembles the payer packet, submits it, and tracks it to resolution.

  • Payer Rule Library
  • Packet Assembly
  • Status Tracking
  • Appeal Drafting
Integration

EHR-embedded, HIPAA-compliant

Coordinators work in the EHR they already use, with full audit logging of every action.

  • EHR-Embedded
  • PHI Secured
  • Audit Logging
  • Human-in-the-Loop
Impact

Under 24-Hour Turnaround in Three Months

Down from six business days, with first-pass denials cut from 18% to 5%.

  • <24 hr Turnaround
  • 5% Denial Rate
  • 30+ Hours Reclaimed
Build your idea

Talk to our experts

Scope your own prior authorization agent with our healthcare AI team.

  • Free Consultation

The Challenge

Manual authorizations delayed care and burned staff hours.

30+ Hrs/Wk
Authorization staff spent more than 30 hours a week on payer portals, hold queues, and fax follow-ups. Every specialty had a different payer mix, and payer rules changed constantly — so even experienced coordinators struggled to submit clean packets the first time.
18% Denials
The result was an 18% first-pass denial rate, driven mostly by missing clinical evidence and mismatched CPT/ICD codes. Average turnaround stretched to six business days, and peak-season backlogs forced procedure cancellations.
No Compromise
The group needed to remove the manual burden without losing clinical oversight or compliance control.

From a 6-day wait
to under 24 hours with
an autonomous auth agent

Talk to Our Team

Our Solution

  • Automated Payer Submission

    Automated Payer Submission

    Automated Payer Submission

    • Matches the order and notes against current payer rules
    • Assembles the packet and submits by portal, fax, or EDI
    • Handles each payer's forms without manual re-keying
  • Real-Time Status Tracking

    Real-Time Status Tracking

    Real-Time Status Tracking

    • Polls payer systems and writes status back into the EHR
    • One live queue of pending, approved, and at-risk authorizations
    • Escalates only real exceptions; clean cases resolve untouched
  • Clinical Documentation Assembly

    Clinical Documentation Assembly

    Clinical Documentation Assembly

    • Pulls the chart evidence each payer needs for medical necessity
    • Drafts necessity letters and validates CPT/ICD pairings
    • Flags documentation gaps upfront, not after a denial
  • Denial Prevention & Appeals

    Denial Prevention & Appeals

    Denial Prevention & Appeals

    • Scores denial risk pre-submission and prompts fixes in time
    • Auto-drafts appeal packets with supporting evidence
    • Tracks appeal outcomes to keep the rule library current
  • Payer Rule Library Upkeep

    Payer Rule Library Upkeep

    Payer Rule Library Upkeep

    • Payer policy changes tracked and versioned as they publish
    • Rule updates tested against recent cases before going live
    • Coordinators see which rule drove each submission decision

Key Challenges We Solved

Hover a row to see what changed.

Why They Chose Us

An agent inside the existing EHR: PHI secured, every action logged, approval thresholds set by staff.

The Results

Every number below was measured in production after launch — not projected in a pitch deck.

<24 hrs

Authorization Turnaround — Down from 6 business days

5%

First-Pass Denial Rate — Down from 18%

30+ hrs

Staff Time Reclaimed Weekly — Redirected to patient care

$210K

Annual Revenue Protected — From prevented delays & denials

Global presence

Three offices. One team.

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