Prior Authorization Agent

Faster approvals mean fewer cancellations, fewer denials, and healthier revenue.

ImpactRCM’s AI Agent handles prior authorizations end-to-end: identifying when an authorization is required, collecting necessary documentation, submitting requests to payers, and monitoring decisions in real-time.

Built to Support Hospitals, Practices & Billing Companies

Prior authorization is one of the biggest bottlenecks in scheduling and reimbursement. Manual calls, payer portals, faxes, and follow-ups slow everything down. Prevents avoidable auth-related claim denialsOur AI Agent automates the entire workflow, determining when an authorization is required, preparing documentation, submitting the request, tracking payer status, and notifying your team instantly when it’s approved or if additional steps are needed.

What It Does

How It Helps You

authorization requests

Features

Automatically checks payer rules, submits authorizations, and tracks status in real time. Prevents back-and-forth and last-minute cancellations.

Procedure-based Authorization Rules Engine

Automated Documentation Collection from EHR/EMR

Electronic Submission & Payer Portal Integration

Real-Time Decision Tracking & Alerts

Exception & Follow-Up Queue Management

Business Impact

Automating prior auths cuts staffing overhead and reduces dependency on manual follow-ups. Hospitals and practices gain more throughput, more billable encounters, and stronger margins.

Faster approvals → fewer scheduling delays

60–80% reduction in auth-related claim denials

Improved coordination between clinical & billing teams

Reduced manual workload, no chasing paperwork

Better patient experience with clear expectations and fewer reschedules

Built for Healthcare Teams

The Prior Authorization AI Agent streamlines patient access, scheduling, and billing operations for high-volume teams. It automatically checks payer requirements, submits and monitors authorizations, and flags only the cases that need Quicker authorizationshuman review. By removing manual follow-ups and portal logins, it ensures predictable workflows, smoother scheduling, and fewer denials keeping teams focused on patients, not paperwork.

Built for healthcare groups aiming to reduce delays, avoid preventable denials, and keep schedules full, all with the same team.

Hospitals & Health Systems

Multi-Specialty Clinics

Physician Groups

Ambulatory Surgery Centers

RCM / Billing Companies

Ready to Simplify Prior Authorizations with AI?

See how the Prior Authorization AI Agent can transform your workflow.

How It Works

STEP 01

Connect to your EHR / PM system

STEP 02

AI Agent verifies insurance & benefits in real-time

STEP 03

Flags exceptions for review (if required)

STEP 04

Updates records automatically

STEP 05

Claims get submitted clean, the first time

Why ImpactRCM

ImpactRCM combines deep RCM expertise with purpose-built AI designed for healthcare workflows, not generic automation. Fewer denials, faster payments, less manual work.

Purpose-built for healthcare RCM, not generic automation

Seamless EHR/PM integration for clean, consistent data flow

Real-time payer verification with accurate benefits and authorization checks

Reduces denials and front-end workload without adding staff