The Prior Authorization Nightmare Ends Here.
Stop wasting hundreds of staff hours on soul-crushing paperwork and phone calls. The Prior Authorization Architect uses AI to build your case, find the evidence, and draft approval-ready letters, cutting submission time by 90%.
See The AI in ActionThe Three Leaks Draining Your Practice
The Time Leak: Staff Burnout
Your most skilled staff spend their days on hold with insurance companies and digging through patient charts for obscure data points, instead of focusing on patient care and revenue-generating activities.
The Care Leak: Delayed Treatments
While your team battles bureaucracy, your patients wait. These delays frustrate patients, disrupt care schedules, and can negatively impact clinical outcomes and satisfaction scores.
The Revenue Leak: Denied Claims
Every incorrectly submitted PA or missed deadline results in a costly denial, triggering a cascade of appeals and write-offs that directly impacts your bottom line.
Plugging All Three Leaks
Imagine an intelligent system that automates the most painful parts of the PA process, ensuring fast, accurate, and evidence-based submissions every single time.
From Patient Chart to Payer Approval: The AI Workflow
Our system is an intelligent layer on top of your EHR. It’s not just automation; it’s clinical and administrative cognition-as-a-service.
1. AI Policy Ingestion
When a PA is triggered, our AI instantly ingests the specific payer's most current clinical policy for that procedure or medication. It knows exactly what they're looking for.
2. Intelligent Chart Review
The Architect hunts through the patient's unstructured chart notes, lab results, and history in your EHR to find the exact clinical evidence required by the policy.
3. Evidence-Based Synthesis
The system synthesizes the findings into a perfectly formatted, medically sound Letter of Medical Necessity, complete with references to the patient data.
4. Staff Review & Submission
Your staff receives a near-perfect submission packet for a quick review and one-click submission. What took hours now takes minutes.
Success Story: A System for Smarter Submissions
Client: A Multi-Specialty Medical Group in Palm Beach County
The Challenge:
Their dedicated PA team of three was drowning in paperwork for complex procedures, leading to an average submission time of 45 minutes per case and a significant backlog that delayed patient scheduling.
The SmartPBC Solution:
We deployed the Prior Authorization Architect, integrating with their existing EHR. The system learned their top 20 most common PA-required procedures and their associated payer policies.
The Results:
The system reduced the active staff time per PA from 45 minutes to less than 5 minutes for review and submission. This allowed the practice to clear their entire backlog in one week and reassign two team members to more valuable patient-facing roles.
*This is a representative case study based on aggregated results from clients in the healthcare sector. Names and specific figures have been changed to protect client privacy.
The SmartPBC Way vs. The Old Way
AI-Powered Precision
Instead of manual searching, you have an AI that finds the exact clinical evidence needed for approval, reducing errors and omissions.
Radical Efficiency
Instead of staff wasting hours on hold, you empower them to handle 10x the volume with less stress and higher accuracy.
Accelerated Care
Instead of patients waiting weeks for approvals, you get procedures scheduled faster, boosting both patient satisfaction and practice throughput.
Predictable Revenue
Instead of fighting surprise denials, you create a system of clean, fast, and evidence-based submissions that leads to a healthier revenue cycle.
Calculate Your Administrative Savings.
In a brief, confidential call, we can help you quantify the immense cost of your current PA process and estimate your potential savings in both staff hours and accelerated revenue.
Schedule My ROI Assessment