AI Prior Authorization Automation for Healthcare

Eliminate Delays with Automated Prior Authorization by HealOS

Prior authorization is one of the biggest bottlenecks in healthcare operations. Manual forms, payer portals, phone calls, and status checks delay care, frustrate staff, and impact revenue. HealOS delivers AI-powered prior authorization automation built for healthcare. Our platform replaces manual pre-authorization work with intelligent workflows that submit requests, track payer responses, and resolve approvals faster. This is modern prior auth software designed for scale.

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Why Prior Authorization Is Broken Today

Healthcare prior authorization workflows were never designed for speed or scale.

Manual data collection from EHRs

Repetitive form filling across payer portals

Missing documentation and errors

Long authorization turnaround times

Poor visibility into request status

High denial rates due to incomplete submissions

Traditional workflows slow care delivery and overload staff. AI prior authorization is no longer optional.

HealOS for Automated Prior Authorization

HealOS is an AI prior authorization solution that automates the full pre-authorization lifecycle. It connects clinical documentation, payer rules, and authorization workflows into one intelligent system reducing delays, denials, and administrative burden.

~21 Days

Typical Go-Live Timeline

90%+ of Requests Automated

Prior Authorization Automation Coverage

100% Pilot Graduation

Deployment Conversion Rate

How HealOS Automates Prior Authorization

Step 1

Authorization Intake

HealOS ingests authorization requests directly from the EHR, scheduling systems, and referrals capturing required patient, provider, and procedure data automatically.

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Step 2

Documentation & Rule Validation

HealOS validates medical necessity, coverage requirements, and payer-specific rules using AI before submission. This prevents avoidable denials in prior authorization automation workflows.

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Step 3

Automated Submission

HealOS submits prior authorization requests electronically through payer portals, clearinghouses, or APIs without manual data entry.

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Step 4

Status Tracking & Follow-Ups

HealOS continuously tracks authorization status across payers and triggers automated follow-ups when delays occur. No more portal hopping or manual calls.

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Step 5

Decision Handling & Updates

HealOS updates approvals, denials, and requests for additional information directly in connected systems, closing the loop in pre-authorization automation.

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Core Capabilities for Prior Authorization Automation

End-to-End AI Prior Authorization Automation

HealOS automates prior authorizations end to end by extracting patient data from the EHR and submitting requests directly into payer portals and authorization systems.

Universal Authorization Form Mapping

HealOS recognizes fields across payer portals and authorization forms, automatically mapping patient, provider, and procedure data with increasing accuracy over time.

Human-in-the-Loop Accuracy Controls

HealOS combines AI automation with human verification for edge cases, ensuring accurate, compliant prior authorization submissions without sacrificing speed or scale.

Fully HIPAA-Compliant Processing

HealOS processes patient data securely with HIPAA-compliant controls, encrypted workflows, and strict handling standards to ensure safe, compliant prior authorization automation.

Measurable Impact Across Operations

See real results from automated prior authorization.

50%

Fewer Denials

10X

Faster Approvals

300+

Hours Reclaimed Monthly

12X

Better Payer Compliance

Who HealOS Is Built For

Hospitals & Health Systems

Scale prior authorization across departments and service lines.

Physician Groups

Reduce staff burden and improve approval timelines.

Behavioral Health Providers

Handle complex authorization requirements efficiently.

Specialty Clinics

Navigate payer variability without adding headcount.

Telehealth Providers

Automate prior authorization for virtual care services.

Security & Compliance

HIPAA Compliant

Secure PHI handling without storage

SOC 2 Type II Certified

Independently audited enterprise security

Secure Authentication

SSO and multi-factor access controls

Frequently Asked Questions

Start Automating Prior Authorization

HealOS delivers AI-powered prior authorization automation that speeds approvals, reduces denials, and scales healthcare operations.

Book a HealOS Demo