Hospital Prior Authorization

An agent that does your prior auths — end-to-end.

It navigates your hospital's systems the same way your staff does: via VPN, through legacy interfaces, into payer portals. But it runs at 2am, never misses a form, and costs a fraction of your billing team.

Admission EHR trigger
ClaimLoop Agent Gathers docs, fills forms
Payer Portal Submitted & tracked

No integration. No IT project.

The agent works inside your existing environment — VPN access, existing systems, legacy interfaces. It doesn't replace your EHR. It works alongside it.

Hospital Systems
EHR
PACS
Billing
Scheduling
Secure VPN
ClaimLoop Agent
Document gathering
Form population
Payer submission
Status tracking
Denial escalation
Payer APIs
Insurance Payers
Medicare
BCBS
Aetna
United

Faster authorizations

Most prior auths submitted within hours of admission, not days. Staff focus on exceptions, not form-filling.

Fewer denials

Agent fills every required field with the right documentation. No missing attachments. No wrong diagnosis codes.

Runs 24/7

Midnight admission? Agent starts the prior auth before morning rounds. No waiting for business hours.

No IT burden

Deployed via secure VPN, just like your staff's access. No EHR integration. No HL7 interfaces. No six-month projects.

What this means for a hospital

2–5 days Average time saved per prior auth submission
40–60% Reduction in denial rates from complete documentation
$400K+ Annual savings for a mid-size hospital on prior auth staff alone
0 IT projects required. Agent goes live in weeks.

The hospital that runs its prior auth with AI agents will outcompete every hospital still doing it manually.

ClaimLoop makes that a reality — not in three years, not as a pilot. Within the quarter.