≤ 7 daysRed
Critical — submit renewal today to avoid a coverage gap before the next visit.
Examples: Behavioral health weekly sessions, chemo cycles already on the calendar.
AI Prior Authorization Agent
Cut prior-auth turnaround from days to minutes — across ~1,000+ payors
QuickAuth is an AI prior authorization automation platform that automatically checks if procedures need prior auth, gathers clinical documentation from your EHR, and submits authorizations across 1,000+ payors via APIs, RPA bots, and AI voice agents. Reduce authorization denials, speed approvals, and free your staff from manual prior auth work.
1,000+
Payor Connections via API/RPA
20-45 Min
Saved per auth (vs manual baseline)*
24/7
Always-on automation
8-12% to <3%
Auth-related denials
Reduce auth-related denials. Automate prior authorization across ~1,000+ payors. Pull data directly from your EHR/PMS. Free your staff to focus on patient care — without hiring another FTE.
HIPAA Compliant
SOC 2 Controls
1,000+ Payors
End-to-End Automation
How QuickAuth runs in ~90 seconds
Detect → Gather → Submit
A live look at the three-step automation flow that replaces hours of payer phone calls and faxes.
Step 1
Detect
Scan the schedule and flag every visit that needs prior auth against payer rules.
Step 2
Gather
Pull clinical notes, labs, and CPT/ICD codes from the EHR and match payer criteria automatically.
Step 3
Submit
File via API, RPA, or AI voice across 1,000+ payers — and track determinations in real time.
Animated illustration of the QuickAuth automation flow. Replaces manual payer phone queues and faxing with an end-to-end AI-driven pipeline.
~1,000+ payor connections
Automated from order to approval
Designed for providers, RCM vendors, and MSOs
What is prior authorization automation?
Prior authorization automation uses AI to handle the end-to-end process of obtaining insurance approval for medical procedures, medications, and services. The healthcare industry could save an estimated $25.7 billion annually by automating manual administrative transactions1, with the average authorization taking 1-2 business days and requiring multiple phone calls and fax submissions2. QuickAuth automates this process by checking whether procedures require authorization, gathering clinical documentation from the EHR, submitting requests to payors via APIs, RPA bots, and AI voice agents, and tracking approval status in real time. The platform supports 1,000+ commercial and government payors and achieves 95%+ approval rates3 by matching clinical criteria to payer requirements before submission. QuickAuth reduces authorization turnaround from days to minutes, cuts auth-related denials, and eliminates hours of staff time spent on payer phone queues. The system is HIPAA compliant and supports the CMS Prior Authorization API requirements (CMS-0057-F) via FHIR R4.
1 Source: CAQH 2024 Index. 2 Source: AMA 2024 Prior Authorization Survey. 3 Based on aggregate customer outcomes. Individual results vary by specialty and payer mix.
Why Healthcare Organizations Choose QuickIntell for Prior Authorization
95%+
Approval Rate
1,000+
Payors Supported
85%
Time Reduction
*Based on aggregate customer outcomes. Source: AMA 2024 Prior Authorization Survey, CAQH 2024 Index. Individual results vary by specialty and payer mix.
- Aetna
- Anthem
- BCBS
- Cigna
- Humana
- UnitedHealthcare
- Kaiser
- Centene
- Molina
- Medicare
- Medicaid
- Tricare
Connected to ~1,000+ commercial, Medicare, Medicaid, and specialty payers.
What Is AI Prior Authorization?
AI prior authorization is the use of artificial intelligence and automation to streamline the prior authorization process in healthcare. Instead of staff manually checking if procedures require authorization, gathering documentation, navigating payor portals, and tracking statuses, AI prior authorization software automates these tasks end-to-end.
QuickAuth is an AI prior authorization automation platform that evaluates CPT, HCPCS, and ICD-10 codes against payor-specific rules, automatically pulls clinical documentation from your EHR/PMS, submits authorization requests via APIs, RPA bots, and AI voice agents, and tracks approvals across 1,000+ payors — reducing authorization denials and freeing your team from manual prior auth work.
The Problem: Manual Prior Authorization Is Stealing Time and Revenue
Manual prior authorization is slow, frustrating, and expensive. Staff waste hours on utilization management, medical necessity documentation, and navigating payor portals — and it's getting worse every year.
⚠️
The Problem
- •Staff spend 20–45 minutes per case bouncing between EHRs, portals, faxes, and phones
- •High-value procedures are delayed or cancelled because auth wasn't started early enough
- •Denials like "no auth", "invalid auth", or "expired auth" quietly erode your margins
- •Schedulers and billers burn out doing low-value, repetitive work instead of higher-impact tasks
- •Patients feel the pain through rescheduled appointments, uncertainty, and long waits
Every manual step adds delay, cost, and risk. Revenue leaks through the cracks.
✨
The Solution
QuickAuth: AI Prior Authorization Automation That Works 24/7. This AI prior authorization software acts as a specialized digital colleague that understands payor rules, reads your clinical documentation, and tirelessly handles referrals, pre-certification, and authorization requests — automatically.
- ✓Automatically detects if prior auth is required for specific CPT/HCPCS, diagnosis, payor, and plan
- ✓Pulls data directly from your EHR/PMS (demographics, insurance, notes, imaging, labs, orders)
- ✓Submits prior auths via payor APIs, web portals (RPA), fax-ready packets, and AI voice calls
- ✓Tracks statuses and follows up on pended or delayed requests — automatically
- ✓Writes back approvals, numbers, dates, and notes into your EHR/PMS and billing systems
You stay in control. QuickAuth just removes the manual work.
Who QuickAuth Is For
This AI prior authorization solution is designed for healthcare providers, RCM companies, MSOs, and ACOs. If prior authorization is absorbing time, causing authorization denials, or delaying care, QuickAuth automates the process for you.
🏥
Single-Specialty Practices
Radiology, Cardiology, Orthopedics, Oncology, Behavioral Health, Gastroenterology, etc.
Fewer auth-related denials
Protect revenue by reducing "no auth", "invalid auth", and "expired auth" denials.
Faster approvals
Accelerate turnaround times from order to approval through automated workflows.
Happier staff and patients
Free your team from repetitive work and reduce patient wait times and reschedules.
No additional FTE needed
Automate prior auth without hiring another full-time employee.
🏢
Multispecialty Clinics & Physician Groups
Large practices managing multiple specialties and complex payor relationships
Standardization across specialties
Consistent prior auth processes and workflows across all your specialties and locations.
Scale without scaling costs
Handle volume growth without proportionally increasing prior auth staff.
Visibility and control
Real-time dashboards show exactly where auths are in the process and what needs attention.
Better patient experience
Fewer last-minute cancellations and reschedules due to missing authorizations.
⚕️
Hospital Outpatient Departments & ASC Networks
Outpatient departments, ASCs, imaging centers, labs, and post-acute providers
Clean auth packets, quick approvals
Automated documentation gathering ensures complete packets that align with payor requirements.
Straight-through processing
Automated prior auths enable hands-off submission and tracking for routine cases.
Specialty-specific rules
QuickAuth understands ASC, imaging, and specialty billing requirements.
Faster service delivery
Reduce delays and cancellations by starting auths early and tracking proactively.
🤝
RCM Vendors, MSOs & ACOs
Revenue cycle management companies managing prior auth for multiple clients
Higher volumes per FTE
Handle more prior auth cases per staff member through automation.
More predictable SLAs
Deliver consistent, reliable prior auth services to your clients.
Differentiated offering
Stand out with tech-enabled prior auth capabilities that competitors can't match.
Scalable infrastructure
Handle growing client volumes without proportional cost increases.
Who Is QuickAuth NOT For?
QuickAuth is designed for organizations that handle prior authorization regularly. If you rarely need prior authorizations (fewer than 10-20 per month), have a fully automated payor mix with no manual auth requirements, or prefer to keep all prior auth work completely in-house without any automation, QuickAuth may not be the right fit. However, if prior authorization is consuming staff time, causing denials, or delaying care delivery, QuickAuth can help automate the process.
How QuickAuth Automates Prior Authorization End to End
This AI prior authorization automation platform transforms utilization management from a manual bottleneck into an automated background process. QuickAuth handles CPT, HCPCS, and ICD-10 code evaluation, medical necessity documentation, and authorization requests across Medicare Advantage, Medicaid, and commercial payors.
🔍
1
Detect – Does This Service Require Prior Authorization?
As soon as a provider places an order or an appointment is scheduled, QuickAuth evaluates procedure codes, diagnoses, and site-of-service. It checks payor- and plan-specific rules and benefit documents, validates eligibility and benefits when available, and returns a clear answer: No auth needed, Auth required, or Auth recommended — with the reason and policy reference.
📋
2
Gather – EHR-Driven Documentation Assembly
For cases that require auth, QuickAuth automatically pulls demographics, insurance, diagnoses, and orders from your EHR/PMS. It reads clinical notes, imaging reports, and lab results to extract indications, prior treatments, and key findings. The system assembles a complete documentation packet that aligns with the payor's medical policy and checklist. Staff no longer chase clinicians for "one more note" — QuickAuth shows exactly what's missing and can often find it in existing documentation.
✅
3
Submit & Track – APIs, Portals, RPA, and AI Voice Agents
Once documentation is ready, QuickAuth submits the request through payor APIs where supported, drives RPA bots through payor portals when APIs don't exist, and uses an AI voice agent to navigate IVR menus and talk to live agents when required. After submission, QuickAuth monitors status (submitted, pending, approved, denied, more info requested), sends alerts for approvals, denials, and time-sensitive pends, orchestrates follow-ups and additional documentation requests automatically, and writes the auth number, dates, units, and notes back into your systems.
Your team works from a single, clean dashboard instead of a maze of payor portals and spreadsheets.
Results You Can Expect from AI Prior Authorization
While exact numbers vary by organization, this prior authorization automation platform is built to drive measurable improvements in denial rates, turnaround times, and staff productivity across your RCM workflows.
🌐
1,000+
Payor Connections
Connected to hundreds of national, regional, and specialty payors via API and RPA bots
⏱️
20-45 Min
Time Saved Per Case
Eliminates manual work bouncing between EHRs, portals, faxes, and phones
🔄
24/7
Always-On Automation
Your AI authorization agent never sleeps — processes auths around the clock
📉
8-12% to <3%*
Auth-Related Denials
Reduction in "no auth", "invalid auth", and "expired auth" denials within 90 days
⚡
3-5 days to <1 day*
Turnaround Times
From order to approval on clean submissions — automated workflows accelerate the entire process
👥
10-14 to 2-4 hrs*
Staff Time per Provider / Week
Free your staff from repetitive prior auth work to focus on higher-impact tasks
Key Prior Authorization KPIs We Improve
QuickAuth helps you track and improve critical prior authorization metrics that directly impact revenue and patient satisfaction.
Auth-Related Denial Rate
Track and reduce denials caused by missing, invalid, or expired authorizations through automated detection and submission
Time to Approval
Accelerate turnaround times from order to approval through automated workflows and proactive follow-up
Manual Touch Time
Reduce manual FTE time per auth case down to 2-4 hours/week per provider (from 10-14)
*Target ranges based on industry benchmarks from CAQH CORE and the AMA 2023 Prior Authorization Physician Survey. Individual results vary by payor mix, specialty, and baseline workflow.
QuickAuth vs. Generic RPA vs. Status-quo Manual
Why teams replace screen-scraping bots and phone-queue workflows with purpose-built prior authorization automation.
| Capability | Status quo manual | Generic RPA | QuickAuth |
|---|---|---|---|
| Multi-channel submission | Phone + fax + portal logins | Portal-only (breaks on UI changes) | API + Portal + AI Voice — auto-routed per payer |
| EHR write-back | Staff retypes auth # into EHR | Not included (bot stops at portal) | Auth #, units, dates synced to EHR encounter |
| AI-drafted appeals | Hand-written letters; 30–45% win rate | No clinical reasoning — out of scope | LCD-cited drafts; 60–70% first-level win rate |
| Renewal Calendar | Spreadsheet trackers; lapses common | No renewal awareness | Auto-alerts at 30 / 14 / 7 days; under 1% lapses |
| Pricing model | FTE salary + benefits per specialist | Per-bot license + maintenance fees | Per-transaction — pay only for completed PAs |
| Implementation speed | Already in place — no lift, no leverage | 8–16 weeks of bot scripting per payer | Live in days via pre-built payer + EHR connectors |
Appeal win-rate and renewal-lapse figures reflect aggregate customer outcomes; individual results vary by specialty and payer mix.
Renewal Calendar
Catch every expiring authorization before the next visit
Recurring authorizations — PT visit packs, chemo cycles, behavioral health sessions — silently expire and create coverage gaps. The QuickAuth Renewal Calendar surfaces every PA approaching itseffectiveTodate and lets your team renew them in bulk.
8–14 daysAmber
Plan the renewal this week — most payers turn renewals around in 3–5 business days.
Examples: PT visit packs, infusion series, recurring durable medical equipment.
15–30 daysYellow
On the radar — pull the latest progress note and pre-stage the cloned draft.
Examples: Specialty pharmacy refills, ongoing radiation treatment plans.
Bulk renew 30 PT authorizations in one pass
Customer scenarioA physical therapy clinic has 30 patients whose 12-visit authorizations expire next month. Instead of opening each PA by hand, the team uses the Renewal Calendar to clone, refresh, and submit them as a batch.
- 1
Filter the calendar
Open the Renewal Calendar from the Prior Auth navigation and filter by service type (e.g. PT) and "expires in 30 days."
- 2
Bulk Renew Selected
QuickAuth clones every selected PA into a draft with the same patient, payer, CPT/ICD-10, and prior supporting docs.
- 3
Refresh dates and units
Update the Service Date Range to the next coverage window and the Units Requested to match the new treatment plan.
- 4
Validate and Submit Batch
Most progress notes auto-pull from the EHR sync. Validate the batch, then submit — drafts move to in_review in minutes.
Outcome: 30 PAs land inin_reviewwithin 30 minutes, expected approval inside 5 business days, and zero patients experience a coverage lapse.
Source: QuickRCM Prior Authorization training manual, § "How to: Renew an expiring authorization" and scenario "Bulk renewal of 30 PT authorizations." The original PA staysapproveduntil itseffectiveTodate passes — never cancel it manually, that creates a coverage gap.
Built for Real-World Operations and RCM Workflows
This AI prior authorization software is built around the way healthcare teams actually work, integrating seamlessly with your existing EHR, PMS, and RCM workflows to automate utilization management and medical necessity documentation.
🔍
Automated Prior Auth Detection
Evaluates procedure codes, diagnoses, and site-of-service against payor- and plan-specific rules to determine if prior auth is required, recommended, or not needed.
📋
Intelligent Documentation Gathering
Automatically pulls demographics, insurance, diagnoses, orders, clinical notes, imaging reports, and lab results from your EHR/PMS to assemble complete documentation packets.
📤
Multi-Channel Submission
Submits prior auths via payor APIs where supported, drives RPA bots through web portals when APIs don't exist, and uses AI voice agents for IVR systems and live agents.
📊
Automated Status Tracking
Monitors auth status (submitted, pending, approved, denied, more info requested) and sends alerts for approvals, denials, and time-sensitive pends.
🔄
Proactive Follow-Up
Orchestrates follow-ups and additional documentation requests automatically, ensuring nothing falls through the cracks.
🔗
EHR/PMS Integration
Writes back approvals, auth numbers, dates, units, and notes into your EHR/PMS and billing systems, keeping everything in sync.
📈
Smart Queues & Prioritization
Organizes work into smart queues (pending approvals, needs more information, approaching service date, denied and appeals-ready) prioritized by service date, urgency, value, and payor SLA.
🤖
AI + Human Review
Routine tasks are fully automated, while high-risk procedures, borderline cases, denials, and appeals are routed for human review with full context.
📝
Comprehensive Audit Trails
Detailed logs of API calls, portal actions, voice interactions, call recordings and transcripts (where permitted), and full audit trails for compliance and internal QA.
Scheduling teams see clear indicators: auth not required, in progress, or approved. RCM teams get structured auth data that aligns with claims and billing. Clinical teams get fewer "please send more notes" pings.
Appeals Workspace
Turn denied authorizations into approvals — without missing a deadline
When a PA comes back deniedor partially_approved, the Appeals Workspace owns the next move: AI-drafted letter, P2P scheduling, deadline tracking, and the full LEVEL_1 → ALJ ladder in one queue.
60–70%
LEVEL_1 win rate
First-level appeal win rates climb from a manual baseline of 30–45% to 60–70% with the AI-drafted letter and LCD-citation workflow.
Source: QuickRCM Prior Authorization training manual, § "Lifts appeal wins." Individual results vary by specialty and payer mix.
AI-drafted appeal letter
QuickAuth pre-generates the appeal letter from the denial reason and the original packet, citing payer policy by name. Edit inline; the clinical claims stay traceable to the chart.
Peer-to-peer scheduler
When the denial letter offers a P2P, capture the payer phone number, time window, and ordering provider in one click. Outcomes — approved, denied, no_show — log to a PeerToPeerReview record on the appeal.
Filing-deadline banner
Most payers give 30–180 days, and missing the date kills the appeal. The banner counts down in business days and pages the queue owner before the window closes.
Appeal Filing Deadline — 7 business days remaining
Aetna LEVEL_1_RECONSIDERATION · denial reason: missing documentation of failed conservative therapy · payer window 60 days.
Submit AppealSchedule P2P
Escalation ladder: LEVEL_1 → LEVEL_2 → LEVEL_3 → ALJ
Tracked end-to-endEvery escalation carries forward the original packet, supporting documents, P2P notes, and prior denial letters. The workspace tells you exactly which level you're at and what deadline matters next — there is no penalty for trying again.
- 1
LEVEL_1— ReconsiderationFirst written appeal back to the payer. AI-drafted letter cites the original packet, the payer's denial reason, and any LCD/NCD policy that supports coverage.
- 2
LEVEL_2— Second-level reviewIndependent payer review when LEVEL_1 is upheld. QuickAuth carries forward every document and adds a fresh clinical narrative.
- 3
LEVEL_3— External reviewThird-party medical reviewer (state DOI or federal IRO). Deadline tracker switches to the external reviewer's clock automatically.
- 4
ALJ— Administrative Law JudgeMedicare and large-payer escalation path. Workspace bundles the full audit trail — every status, every document, every P2P note — into the ALJ packet.
Source: QuickRCM Prior Authorization training manual, § "How to: File an appeal on a denied PA" and § "Schedule a peer-to-peer (P2P) review." Status flow: denied → appealed → appeal_approved or escalate to the next level.
Connected to 1,000+ Payors via APIs, RPA, and AI Voice
This AI prior authorization solution integrates with your existing EHR and RCM workflows, connecting to virtually any payor through APIs, RPA bots, and AI voice agents. Support for Medicare Advantage, Medicaid MCOs, commercial plans, and specialty payors ensures comprehensive coverage.
🌐
Connected to ~1,000+ Payors
Connectivity to hundreds of national, regional, and specialty payors via API and RPA bots. Support for Medicare Advantage, Medicaid MCOs, commercial plans, and niche payors (radiology, oncology, behavioral health, home health, DME, and more).
- •National and regional payors
- •Medicare Advantage plans
- •Medicaid MCOs
- •Commercial insurance plans
- •Specialty payors (radiology, oncology, behavioral health, home health, DME)
🔗
Deep EHR/PMS Integration
Standards-based connections using FHIR and HL7 where available. Flat-file and SFTP pipelines for smaller or legacy systems. RPA-based screen automation when APIs don't exist.
- •FHIR and HL7 interfaces
- •REST APIs
- •Flat-file and SFTP pipelines
- •RPA-based screen automation
- •Multi-tenant design supporting multiple locations, NPIs, TINs, and provider entities
⚡
Fast "Overlay" Start
If you're not ready for full integration, you can start with a lightweight overlay: upload a simple file or enter minimal case details into the QuickAuth portal, let QuickAuth handle the auth process, and move to deeper EHR integration once you've proven value.
- •Lightweight portal-based workflow
- •File upload capabilities
- •Manual case entry option
- •Gradual migration to full integration
- •Prove value before committing to deep integration
QuickAuth Pulls From Your Systems
- Patient demographics and insurance coverage
- Diagnoses, problem lists, medications, and prior procedures
- Orders, encounters, clinical notes, imaging, and labs
- Scanned documents and uploads
QuickAuth Writes Back To Your Systems
- Auth number, type (initial, concurrent, extension)
- Effective and expiration dates, units authorized
- Summary notes and key payor conditions
- Denial reasons and next steps for downstream RCM
If a plan isn't yet connected, QuickAuth can handle it with generic RPA/manual-in-the-loop workflows initially, then build dedicated bots or integrations and add them to your rules engine over time.
Security, Compliance, and Healthcare-Grade Privacy
QuickAuth is designed for healthcare-grade security and HIPAA compliance — you get AI prior authorization automation without compromising on security, privacy, or auditability. Built for providers, RCM vendors, and MSOs managing PHI.
🔒
HIPAA-Aligned Design
Encryption in transit and at rest, with strict access controls and audit logging for all PHI access and modifications.
👥
Role-Based Access Controls
Strict role-based access controls for front desk, billing, clinical, and admin users, ensuring each user only sees what they need.
☁️
Secure Cloud Infrastructure
Data stored in secure, healthcare-ready cloud environments with strong tenant isolation and regular security audits.
📋
Business Associate Agreements
Support for Business Associate Agreements (BAAs) and enterprise security reviews as part of the standard onboarding process.
📊
Comprehensive Audit Trails
Full audit trails for compliance and internal QA, including detailed logs of all API calls, portal actions, and voice interactions.
🤖
AI You Can Trust
AI + rules + human review design ensures high-risk procedures and borderline cases are routed for human review with full context.
You stay in control, while the AI does the heavy lifting.
Every step is tracked with detailed logs, call recordings and transcripts (where permitted), and full audit trails for compliance and internal QA.
Frequently Asked Questions
Everything you need to know about QuickAuth AI Prior Authorization Agent — 45 comprehensive answers to help you make an informed decision
Showing 5 of 5 FAQs in General FAQs
Still have questions?
Our team is here to help. Book a discovery call to see QuickAuth in action and get answers to your specific questions.
Book a 20-Min Discovery CallComplete Your RCM Automation
QuickIntell — AI Eligibility Verification
Run eligibility upstream of prior auth — the same coverage check surfaces which visits need authorization, so PA detection is triggered automatically.
QuickVoice — AI Voice Agents
Handle payer calls automatically with AI voice agents that complete prior auth calls, eligibility checks, and claim follow-ups.
QuickRCM — End-to-End AI RCM
Automate the full revenue cycle from eligibility through payment posting. Greater than 95% first-pass acceptance.
QuickERA — Payment Posting Automation
Convert EOBs into 835 ERAs automatically. Streamline payment posting across 3,500+ payors.
AI in Revenue Cycle Management Guide
Learn how AI is transforming healthcare RCM — from automated prior auth and coding to predictive denial management.
Compare QuickAuth
Ready to Stop Fighting Prior Authorizations?
If your teams are spending too much time on portals, faxes, and hold music, it's time to give them an AI colleague built specifically for prior auth.
QuickAuth helps you automate prior authorization end-to-end across 1,000+ payors, protect revenue by reducing auth-related denials, and free your staff to focus on higher-value, patient-facing work.
No credit card required
HIPAA & SOC 2 compliant
Fast, phased implementation
Pilot in weeks, not years