Most deployments go from kickoff to production-live in 4–6 weeks via our AI Velocity Pod model. We integrate with your existing EHR and billing system — there is no rip-and-replace.
AI Healthcare Automation
Prior Authorizations Shouldn't Take Days While Patients Wait — We Cut It to Minutes
We build AI solutions that auto-extract clinical justification from patient records, match payer rules in real time, submit complete authorization requests, and track every follow-up — fewer denials, faster care, less burnout.
87%Faster approvals
62%Denial reduction
4 wksTo production
HIPAACompliant build
AI Prior Auth Engine
LIVE
Processing: MRI Lumbar Spine — UnitedHealth · Patient: James H.
Step 1 — Clinical Extraction
Extracted DX: M54.5 + prior PT notes, radiology orders, physician attestation
Source: Epic EMR · 3 documents parsed
Step 2 — Payer Rule Match
UnitedHealth LCD L35072 satisfied · Clinical necessity confirmed
Payer DB: 1,400+ active policy rules
Step 3 — Auth Request Submitted
FHIR-compliant packet sent · Ref #: UH-2026-089341
Via: CoverMyMeds API integration
Step 4 — Follow-Up Tracking
Auto-ping at 24h · Peer-to-peer flag suppressed — criteria complete
No human touchpoint required
APPROVED — 6 minutes 22 secondsvs. industry avg of 3.1 days · Zero staff hours used
Elapsed: 0:00 · Restarting shortly
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India TodayNation's Newsroom
ANI NewsAsia's Leading Wire
Y!
Yahoo FinanceGlobal Business
PTIPress Trust of India
BS
Business StandardIndia's Benchmark
Tribune IndiaSince 1881
Business TodayIndia Business
The WireInvestigative Media
The HinduSince 1878
India TodayNation's Newsroom
The Real Cost
Prior Auth Is Breaking Your Revenue Cycle — and Your Staff
Manual prior authorization is the single biggest bottleneck in modern healthcare delivery. Every delay is a denied claim, a delayed procedure, or a burned-out clinician.
Clinical Staff Spend 2+ Hours Daily on Auth Alone
Nurses and MAs manually log into payer portals, copy-paste clinical notes, and chase approvals while patients wait. This is not care delivery — it is data entry at clinical cost.
Payer Rules Change Monthly — Staff Cannot Keep Up
With thousands of active payer policies, even experienced staff submit incomplete requests, triggering avoidable peer-to-peer calls and denial appeals that consume weeks of follow-up.
Denials Cost $25–$118 Each to Re-Work
Every denied authorization re-enters a manual queue. Physicians write appeal letters. Billers resubmit. Revenue stalls. Margins shrink. Patients continue to wait for approved care.
No Real-Time Visibility Into Request Status
Hours on hold with payer lines. No live tracking dashboard. Coordination breakdowns between scheduling, billing, and clinical teams create cascade delays across the entire system.
45.8M
Prior auth requests processed annually in the US. 94% could be automated — yet most health systems still rely entirely on manual workflows.
Avg days for a standard auth3.1
Weekly staff hours lost per FTE14.9h
Physicians who delayed care due to auth93%
First-pass denial rate (manual)17%
Denial reduction with Ailoitte AIDown 62%
The Solution
End-to-End AI Authorization — From Chart to Approved in Minutes
Four coordinated AI stages replace the entire manual authorization workflow, running in parallel, 24/7, without a single payer portal login from your staff.
01
Clinical Data Extraction
AI reads EHR notes, labs, imaging orders, and physician attestations — pulling exact ICD-10/CPT codes and clinical justification with 99.1% accuracy.
02
Real-Time Payer Rule Match
Cross-references 1,400+ active payer policies, LCDs, and coverage criteria in real time. Detects coverage gaps before submission — not after denial.
03
Smart Request Submission
Builds and submits complete, payer-formatted packets via FHIR, X12, or portal APIs — including all clinical documentation automatically.
04
Automated Tracking
Real-time dashboard visible to all teams. Auto-reminders at payer deadlines. AI-generated peer-to-peer prep packets when escalation is needed.
Deployed via our AI Velocity Pod model — production-ready in 4 weeks.
Get My Custom Deployment PlanUse Cases
One Platform. Every Specialty. Every Payer.
From oncology to behavioral health, our AI adapts to the clinical context, payer requirements, and urgency level of every request.
Oncology Prior Auth — Days to Hours
Chemotherapy and immunotherapy authorizations are notoriously complex — multi-drug regimens, biomarker requirements, step therapy mandates. Our AI maps every component against payer criteria simultaneously, submits with NCCN guideline citations, and tracks each drug’s auth status independently.
91%First-pass approval rate
4.2hAvg auth vs 5.1 days
0Manual portal logins
$340KAnnual staff savings est.
AI Auth Engine Terminal
ROI Calculator
The Math Is Simple: Recover Denied Revenue
Healthcare organizations typically recover $280K–$1.2M annually after deploying Ailoitte's prior auth automation.
Configure Your Organization
Monthly Auth Requests 800
Auth Staff (FTEs) 6
Avg Staff Hourly Cost $32
Current First-Pass Denial Rate 17%
Avg Revenue per Authorized Procedure $1,200
Projected Impact
752 / mo
564 hrs
$216,576 / yr
5.9% (was 17%)
$1,278,720 / yr
Projected Annual Savings
$1,495,296
Staff savings + denial revenue recovery combined
Common Questions
Our payer rules engine is updated continuously — typically within 72 hours of a policy change. It covers 1,400+ active payer policies including Medicare LCDs and Medicaid plans.
Every Ailoitte healthcare deployment includes a signed BAA, zero PHI retention outside your environment, and SOC 2 Type II-compliant infrastructure. PHI is never used for model training.
Yes. Urgent requests are automatically flagged and routed through expedited pathways, with auto-monitoring at 4-hour intervals.
Ready to Cut Auth Time from Days to Minutes?
Book a 30-minute live demo — we will show you what automated prior authorization looks like for your organization.
No commitment HIPAA-safe 4 weeks live
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