Problems

What will AGI do for Surgical Prior Authorization Delays?

Medical practices and hospital surgical departments lose weeks waiting for health insurers to approve scheduled procedures. To secure prior authorization, clinical staff manually extract evidence of medical necessity from unstructured physician notes and match it against highly specific payer guidelines. This friction causes costly procedure cancellations and severe care delays for patients.

The opportunity

What AGI will do for Surgical Prior Authorization Delays

  • Automated Payer Approvals for Orthopedics

    Business-as-Code

    Solves:

    Platform.do
  • Medical Necessity Generation for ASCs

    Business-as-Code

    Solves:

    Platform.do
  • Pre-Auth Scrubbing for Surgical Clinics

    Business-as-Code

    Solves:

    Platform.do
  • Payer Portal Automation for Surgeons

    Business-as-Code

    Solves:

    Platform.do
  • Autonomous Coding for Surgical Authorizations

    Business-as-Code

    Solves:

    Platform.do

The work itself

Grounded Work Profile

Tools

  • Epic PreludeproblemCurrentSolutions
  • Availity EssentialsproblemCurrentSolutions
  • Waystar Prior AuthorizationproblemCurrentSolutions
  • Experian HealthproblemCurrentSolutions
  • Microsoft ExcelproblemCurrentSolutions

Measured by

  • Severity 4/5problemSeverityFrequency
  • continuousproblemSeverityFrequency

Value flow

How Surgical Prior Authorization Delays connects

candidate solution for

  • Claricamodel
  • Cornelectivemodel
  • Covurgerymodel
  • Mandatematrixmodel
  • Packetmanifestmodel
  • Surgicalimagemodel

entails

  • Gold Carding Eligibilitymodel
  • Initial Authorization Submissionmodel
  • Payer Policy Decodingmodel
  • Peer To Peer Escalationmodel
  • Portal Data Entrymodel
  • Preoperative Clinical Documentationmodel

used for

  • Availity Essentialsmodel
  • Epic Preludemodel
  • Experian Healthmodel
  • Waystar Prior Authorizationmodel
  • Microsoft Excelmodel

How AGI delivers it

Four ways AGI delivers

  • Services-as-Software

    Get the professional outcome delivered as software, priced on results, not headcount.

    Services.do
  • Autonomous Agents as digital employees

    Hire a digital employee that does the job under earned, supervised autonomy.

    Agents.do