AI Prior Auth reads the patient's chart, drafts answers to the payer's actual portal questions, and fills the portal only after a person has approved them. It is deliberately not a one-click submitter.
How a run works
- Connect the portal. Open Prior Auth, connect the secure browser, and sign in with your own practice account on the payer portal. Your credentials are entered in the portal, never stored in HealOS. A session lasts about twenty minutes and can be disconnected at any time.
- Load the chart. Choose New request to load the patient's chart, or Use an existing draft and give its request key. HealOS checks the chart belongs to your connected practice, and that name and date of birth on the portal match the chart.
- Capture the real questions. HealOS reads the questions the payer form actually shows for that drug and that form — not a generic template.
- Draft answers from evidence. Draft answers from evidence fills the answers it can support from the chart — recorded values with their dates, documented diagnoses, practice details — and cites the record behind each. Missing evidence stays unknown; it never becomes a "no". Anything narrative is matched to a quoted passage from a signed visit note, quoted exactly, or left for you.
- Review and approve. You check every answer and its source, then approve the revision. If the form reveals new conditional questions, the approval clears and you review again.
- Fill the portal. Fill approved answers writes the approved answers to the draft and verifies them by reloading and reading them back.
The limits, stated plainly
- HealOS never submits to the plan. It fills and saves the draft. Sending it is yours.
- Anything ambiguous stops the run rather than guessing — an unfamiliar control, a changed question, a request in a state it does not recognise.
- Treatment failure, adherence, diet-program participation and stable dosing are never inferred from records. Those are your clinical statements.
- A quotation proves where text came from, not that it is clinically sufficient. Read the sources before approving.
Getting it turned on
Prior Auth is enabled per practice, with the payer portal and EHR combination set up with you, because each payer form has to be validated before we let it be filled. Ask support and we will tell you where your payer and EHR stand today.