Prior authorization, done in hours - not days

Prior authorization, done in hours - not days

Enterprise-grade AI that slashes prior auth cycle times, cuts denials, and reduces operational cost across your network.

Enterprise-grade AI that slashes prior auth cycle times, cuts denials, and reduces operational cost across your network.

Lift administrative burden with fewer clicks and less typing

Lift administrative burden with fewer clicks and less typing

Catch missing documentation before submission, not after

Catch missing documentation before submission, not after

Reduce repeat AIR cycles and speed up time to care

Reduce repeat AIR cycles and speed up time to care

Home

Prior Authorization Agent

Why does prior authorization keep slowing patient care?

elsai transforms ad hoc, manual work into governed, agentic workflows that deliver consistent outcomes.

elsai transforms ad hoc, manual work into governed, agentic workflows that deliver consistent outcomes.

01

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80–90% of PA requirement checks are still manual and payer specific 

80–90% of PA requirement checks are still manual and payer specific 

02

02

02

20–40% of PA packets go out incomplete or misaligned to policy  

20–40% of PA packets go out incomplete or misaligned to policy  

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03

03

30–50% of cases receive at least one AIR, adding 2–5 days per cycle 

30–50% of cases receive at least one AIR, adding 2–5 days per cycle 

04

04

04

Clinicians and nurses face repeated chart reviews and documentation requests. 

Clinicians and nurses face repeated chart reviews and documentation requests. 

See how elsai changes this →

How does the elsai PA agent run your workflow?

How does the elsai PA agent run your workflow?

Step 01

Auto-detect new PA tasks

Auto-detect new PA tasks

Monitors your EHR/RCM and routes new requests to the right workflow instantly.

Monitors your EHR/RCM and routes new requests to the right workflow instantly.

Step 02

Get payer-ready data

Get payer-ready data

Pulls orders, eligibility, and clinical info—no document chasing needed.

Pulls orders, eligibility, and clinical info—no document chasing needed.

Step 03

Verify PA need and gaps

Verify PA need and gaps

Checks payer rules and highlights only genuine missing details.

Checks payer rules and highlights only genuine missing details.

Step 04

Build a clean submission packet

Build a clean submission packet

Auto-fills forms and compiles docs for rapid review and send-off.

Auto-fills forms and compiles docs for rapid review and send-off.

Step 05

Track progress to resolution

Track progress to resolution

Monitors statuses and deadlines, alerting staff before any SLA risk.

Monitors statuses and deadlines, alerting staff before any SLA risk.

Watch a sample intake flow →

Agentic AI orchestration for prior authorization

Agentic AI orchestration for prior authorization

The elsai PA Agent automates prior authorization tasks like requirement checks, documentation, and AIR handling with smart routing and human oversight.

The elsai PA Agent automates prior authorization tasks like requirement checks, documentation, and AIR handling with smart routing and human oversight.

Requirement determination agent

Evaluates new orders using payer rules, history, and policy intelligence to determine PA need and next steps.

Document completeness agent

AIR handling agent

Requirement determination agent

Evaluates new orders using payer rules, history, and policy intelligence to determine PA need and next steps.

Document completeness agent

Checks clinical docs against payer rules to flag and fix gaps before submission.

AIR handling agent

Resolves vague AIRs and documentation gaps to prevent repeat denials.

Governance line: All agents are governed by ARMS. Every action is logged, explainable, and bounded by guardrails and mandatory human review on low confidence cases.

Provider‑first, EHR‑integrated PA automation

Provider‑first, EHR‑integrated PA automation

Assign agents to work with your existing tools and deliver results to your usual interfaces, without replacement.

Assign agents to work with your existing tools and deliver results to your usual interfaces, without replacement.

Systems

Connect with EHR and practice management for orders, scheduling, and documentation.

Integrates with RCM tools, payer portals, and phone/fax-to-PDF workflows.

Sends determinations, auth numbers, AIR notes, and status updates directly in existing systems.

Users

PA nurses and coordinators

Revenue cycle and patient access teams

Service line and clinical operations leaders

Discuss your EHR/payer links →

Less administration work. Faster, safer decisions.

Less administration work. Faster, safer decisions.

Faster decisions

Real-time PA checks and minutes to "packet-ready" for quicker care.

Fewer denials and AIRs

Resolve information gaps and improve docs; respond clearly to payer queries.

Less burnout

Staff focus on exceptions, sending precise clinician requests.

Better patient access

Fewer last-minute cancellations and delays.

Powered by ARMS (Agent Resource Management System)

Full audit trails for every decision, packet, and AIR response

Explainable logs tied to rules, policies, and evidence

Policy-based guardrails, automation thresholds, and human review controls

See ARMS and reporting →

Start small. Prove it. Expand

Start small. Prove it. Expand

Begin with one area, measure the impact, then scale to more service lines or payers.

Begin with one area, measure the impact, then scale to more service lines or payers.

Review and choose

Identify one or two high-volume service lines or payers where delays hit hardest. 

Connect and configure 

Link your EHR, queues, and payer systems; define automation rules and review points. 

Pilot and refine

Test with real cases, assess results, then expand as confidence grows. 

Frequently asked questions

Frequently asked questions

Questions teams ask before they turn PA agentic

Questions teams ask before they turn PA agentic

Does this replace our EHR or current PA tools?

No. The elsai PA Agent layers over your EHR, RCM, and payer systems. Your core platforms stay the source of truth while elsai handles checks, completeness, and AIR orchestration.

Does this replace our EHR or current PA tools?

No. The elsai PA Agent layers over your EHR, RCM, and payer systems. Your core platforms stay the source of truth while elsai handles checks, completeness, and AIR orchestration.

Do we have to change our workflows?

Not many changes — you’ll keep using your current systems and channels, while elsai automates the work behind the scenes.

Do we have to change our workflows?

Not many changes — you’ll keep using your current systems and channels, while elsai automates the work behind the scenes.

Can we control automation vs. Review?

Yes. You control automation with thresholds and guardrails, ensuring only high‑confidence cases run automatically while others go for human review.

Can we control automation vs. Review?

Yes. You control automation with thresholds and guardrails, ensuring only high‑confidence cases run automatically while others go for human review.

How fast can we start?

Organizations usually begin with a pilot in one service line or payer to prove value before expanding across others, ensuring a smooth rollout.

How fast can we start?

Organizations usually begin with a pilot in one service line or payer to prove value before expanding across others, ensuring a smooth rollout.

Is PHI protected?

Yes. elsai runs in a secure, HIPAA-aligned environment with encryption, role-based access, and audit logging to keep PHI and your data protected.

Is PHI protected?

Yes. elsai runs in a secure, HIPAA-aligned environment with encryption, role-based access, and audit logging to keep PHI and your data protected.

Ready to make prior authorization truly provider first

Ready to make prior authorization truly provider first

See how elsai PA Agent streamlines your PA workflow—automating checks, filling gaps, and managing AIRs.

See how elsai PA Agent streamlines your PA workflow—automating checks, filling gaps, and managing AIRs.

elsai

Enterprise AI governance platform for agentic workflows. Transform your operations with confidence.

Offices

USA

UK

Australia

UAE

India

© 2026 elsai. All rights reserved.

elsai

Enterprise AI governance platform for agentic workflows. Transform your operations with confidence.

Offices

USA

UK

Australia

UAE

India

© 2026 elsai. All rights reserved.

elsai

Enterprise AI governance platform for agentic workflows. Transform your operations with confidence.

Offices

USA

UK

Australia

UAE

India

© 2026 elsai. All rights reserved.

elsai

Enterprise AI governance platform for agentic workflows. Transform your operations with confidence.

Offices

USA

UK

Australia

UAE

India

© 2026 elsai. All rights reserved.

elsai

Enterprise AI governance platform for agentic workflows. Transform your operations with confidence.

Offices

USA

UK

Australia

UAE

India

© 2026 elsai. All rights reserved.