AUTOMATION AGENT
Streamline prior authorization submissions with fewer clicks and less effort
Managing prior authorization requests for physical and occupational therapy can be a time-consuming and complex process. Initiating prior authorizations often involves logging into multiple payer portals, navigating through screens, and entering patient information. For healthcare staff, staying on top of this process can lead to delays, added workload, and potential disruptions in patient care.
Our Prior Authorization Initiation Automation Agent integrates seamlessly with Optum—a leading benefits management platform —to streamline the initiation of physical therapy (PT) and occupational therapy (OT) prior authorization requests. By automating the initiation workflow, our agent interacts directly with Optum’s portal, efficiently entering patient details and submitting authorization requests.
This automation minimizes the need for manual intervention, requiring staff input only when explicit human specialist input is necessary. With the agent operating in the background, your team can focus on other critical tasks, enhancing overall productivity and patient care.
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, this technology integrates smoothly into your existing workflows.
HOW WE ENHANCE YOUR OPTUM PRIOR AUTH WORKFLOW
Initiate prior authorizations without leaving your system
Optum works with over 60,000 physicians, including PT and OT providers, to enable digital communication with a network of payers, making them a valuable partner in obtaining prior authorizations. Still, the manual tasks involved with submitting the request via Optum–leaving your system, logging in, and navigating the portal–take time and focus. With high volumes of authorizations, the clicks add up.
Our automation agent takes that work off your staff’s plate–completing the steps through Optum’s portal to submit requests to various connected payers.
- Uses attended automation (RPA) to handle repetitive tasks automatically, asking for human intervention only when necessary.
- Reduces manual workload by eliminating the need for staff to log into Optum’s portal or manually enter authorization details.
- Improves efficiency and accuracy by handling routine tasks seamlessly while your staff focuses on higher-priority tasks.
Our Patient Access Plus platform clients benefit from additional API and RPA automation agents that connect to other clearinghouses and benefit managers, including Cohere, Cigna Ash, Carelon, and others providing comprehensive support for PT/OT authorization initiation across a variety of payers.
HOW IT WORKS
A fully automated solution for initiating therapy prior authorization requests
Once a PT/OT prior authorization request is ready, our attended automation agent takes over the initiation process. Here’s how it works:
Your system triggers automation agent
When a therapy authorization request is created, the automation agent is automatically triggered, logging into Optum’s payer portal and entering the necessary patient and procedure information.
Automation agent interacts with Optum’s portal
The agent completes all necessary steps for the initiation process—logging into the payer portal, entering patient details, submitting forms, and answering questions where needed.
Human intervention only when necessary
If the automation agent encounters a step it cannot handle (e.g., additional questions or new requirements), the system will pause and notify a user to intervene. The user can quickly address the issue and allow the automation to continue.
System updates with authorization status
Once the request is submitted, the automation agent logs the authorization status and updates your system, ensuring all data is readily available in real-time.
By automating the initiation process with Optum, our solution ensures faster and more accurate authorization submissions while allowing your team to focus on higher-value tasks.
