AuthPriordocs

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You send us a patient and a procedure. We work out whether it needs prior authorization, assemble the request, get it in front of a clinician for release, submit it, chase the payer, and tell you what came back.

#Who this is for

You are building something that needs prior authorizations done - an EHR assistant, a revenue-cycle workflow, a scheduling agent, or an orchestration platform like IBM watsonx Orchestrate, AWS Bedrock, Google Vertex or Azure AI Foundry. You do not want to learn X12, and you should not have to.

You never touch a clearinghouse
You do not need an Availity account, a trading partner agreement, or any knowledge of the 278 transaction. Those are ours. You send a task and read a result.

#The one thing that will shape your integration

Every authorization stops for a human
A licensed clinician at the practice releases each submission before it reaches a payer. Your integration cannot skip it, approve it, or configure it away - and neither can we. Expect a task to sit in input-required for minutes or hours, and design for that rather than around it.

This is the single most common thing integrators get wrong. See When it waits for a human.

#What you need before you start

ThingWho provides itWhy
A signed agreementYou and usCovers the data flow. Nothing connects before it exists.
A BAAYou and us, or you and the practiceYou will be handling protected health information.
Client credentialsUs, after the agreementA client id and secret scoped to your integration.
A practice that has authorised youThe practiceYour credentials reach only the practices that granted you access, with only the scopes they granted.
A sandbox runYouEvery integration starts against synthetic data. No exceptions.

#How long it takes

  1. Day one
    Credentials, sandbox access, first successful call against synthetic data.
  2. Week one
    The full lifecycle end to end in sandbox, including a task that waits for a release and one that comes back denied.
  3. Before production
    Your handling of input-required reviewed, your retry behaviour checked, and the first practices connected on canary.

#Where to go next

Connect
Credentials, tokens, and what a practice grants you.
Your first request
A complete worked example, start to finish.
When it waits for a human
The part most integrations get wrong.
What you can ask for
The tasks we accept, in plain terms.