Insurance Pre-Approval
Pre-approval requests prepared for staff review. The AI agent checks what the insurer or TPA needs, gathers supporting records from your systems and prepares the request for your staff to approve and send.
Pre-approval request
Draft · prepared by Indite
- Insurer checklist
- Doctor’s notes
- Lab report
- Imaging reportMissing
Insurer reply
More information requested
Overview
When a doctor orders a procedure, test or medicine, the patient’s insurer may need to approve it first. In the US this is called prior authorization. In India, it’s pre-authorization for cashless treatment, and in Canada, some drug plans call it special authorization.
Each request needs the right forms, the right supporting records and someone to follow it until the insurer responds. Indite builds AI agents that do the preparation work, so your staff can focus on reviewing and approving.
Challenges
Requirements are different for every insurer
Each insurer, TPA and plan can ask for different forms and documents, and these requirements change over time. Staff have to check them for every request.
Records are spread across systems
Doctor’s notes, lab reports, imaging and past treatment details often sit in different places. Collecting them takes time.
Missing documents slow things down
If a document is missing, the insurer may ask for more information, and the patient waits longer for treatment.
Replies are hard to keep track of
Insurer responses arrive by email, portal or phone. Without one place to track them, requests can be missed.
Solution
Indite sets up an AI agent for each step, connected to the systems you already use. Your staff approves every request before it’s sent.
Find what the insurer needs
The agent checks the insurer’s guidelines and plan documents you provide for the ordered service. It creates a checklist with a reference for each requirement and flags unclear cases for staff.
Gather the supporting records
The agent pulls only the records it’s allowed to access from your EHR and document systems and matches them to the checklist. Each item links back to its source, and missing items are flagged.
Prepare the request for staff approval
The agent drafts the request using only information found in the patient’s records. Your staff checks the evidence, makes any changes and approves it before it’s sent through the insurer’s usual channel.
Keep track of insurer replies
Replies received by email, or entered by your staff, are added to the request record. When the insurer asks for more information, the agent creates a task for your staff with the insurer’s reason and deadline.
Connects with: your EHR (through FHIR or other APIs), document storage, email, and Microsoft Teams or Slack for staff tasks.
Business Impact
The preparation work moves off your staff’s desk, and every decision stays with your team.
A prepared request to review
Staff start from a draft with supporting records attached, not from a blank form.
Missing documents found earlier
Gaps are flagged against the insurer’s checklist before the request is sent.
One record for every request
What was sent, where each document came from, what the insurer replied and who owns the next step.
Staff approval at every key step
Nothing is sent to an insurer without your team’s sign-off.
See how this would work for your team
Tell us how it works today. We’ll show you how an AI agent could handle it, where your staff stays in control and what it would cost.