AUTOMATION AGENT
Automate Optum therapy prior authorization status follow-ups with ease
Managing prior authorizations for physical and occupational therapy can be complex and time-consuming. Since most payers require the ordering physician to initiate an authorization, therapy providers often require follow-ups on prior authorizations initiated by the ordering provider rather than starting a new request. Additionally, there may be times when therapy staff initiates an authorization but lacks the bandwidth to continuously check for updates—leading to delays and administrative strain.
Optum plays a critical role in aggregating real-time prior authorization data, connecting providers with payers to streamline access to approvals. Yet, therapy practices may still face delays and manual follow-ups, leading to increased administrative burden and potential disruptions in patient care.
We enhance Optum’s capabilities by leveraging our prior authorization follow-up automation agent to eliminate manual status checks of already initiated therapy authorizations. Prior auth approvals are automatically tracked and direct updates are made in your EMR.
Available as part of our Patient Access Plus platform’s prior authorization module or as a standalone automation agent in our Revenue Cycle Agent Platform, providing the flexibility to automate therapy prior authorization follow-ups in a way that aligns with your existing workflows.
HOW WE ENHANCE YOUR OPTUM PRIOR AUTH WORKFLOW
Delivering therapy authorization updates to your EMR
Eliminate manual tracking and ensure real-time prior authorization updates flow directly into your EMR—without staff intervention.
- Our automation agent logs into Optum, retrieves the latest prior auth updates, and syncs them with your EHR, so staff no longer have to check for updates manually.
- Automated EMR updates ensure approved, denied, or pending statuses are reflected automatically, keeping staff informed.
- Scalable automation handles high volumes of authorizations, reducing administrative workload.
With real-time alerts, proactive tracking, and automatic documentation updates, therapy practices can stay ahead of authorization status changes and reduce delays in patient care.
While Optum connects providers to many payers, not all therapy payers are included. For our Patient Access Plus platform clients, our other agents help fill in these gaps by integrating with other clearinghouses and benefit managers like Availity, Evicore, and Carelon to ensure complete prior auth follow-up coverage.
HOW IT WORKS
A fully automated solution for tracking therapy authorization status
Once a therapy prior authorization request is submitted, our automation agent takes over, ensuring timely updates and reducing manual effort.
EMR triggers automation agent
When an authorization request status changes (e.g., Pending Review), the automation agent is automatically assigned the follow-up task.
Authorization status retrieval
The automation agent retrieves the latest status (Approved, Denied, or Pending) and approval or denial details directly from Optum.
System updated with status
Your EMR is automatically updated with the latest authorization status, details, and attachment letters, ensuring real-time visibility for your staff.
Ongoing follow-ups
For unresolved cases, the automation agent re-engages with Optum at set intervals (e.g., every 6 hours) until a final decision is reached.
By automating the follow-up process, we help therapy providers to leverage Optum more effectively, ensuring that every prior authorization request is tracked, updated, and managed—without manual intervention and without leaving your systeem.
Ready to automate physical therapy prior authorization status checks with Optum?
With our Optum therapy prior authorization follow up automation agent, you can eliminate manual follow-ups for physical and occupational therapy authorizations. Get updates sent directly to your EMR, reducing administrative workload and ensuring accurate information. Schedule a demo to learn more.