AUTOMATION AGENT
Automate prior authorization submissions with ease
Manual lab prior authorization processes can be time-consuming and error-prone due their high volume and frequent ambiguity. From gathering clinical documentation to manually submitting requests and checking statuses, the administrative burden falls heavily on lab staff—often leading to delays, claim denials, and frustrated patients.
Our automation agent integrates with TRICARE to handle the admin work of submitting authorization requests to payers, prompting staff when additional input is needed. The agent works through our Patient Access Plus platform's prior authorization module–which can be integrated with your LIS system–to initiate a prior authorization request with TRICARE.
This closed-loop workflow eliminates the need for manual intervention at each step and significantly reduces administrative workload, accelerating approval times. Supported by automation, your team can spend more time focusing on delivering high-quality care and timely diagnostic services.
Easy Prior AUTHORIZATION submissions
Submit prior auths to TRICARE from your LIS
TRICARE significantly improves prior authorization by digitally connecting providers with payers—but manual tasks remain, creating delays. With our automation agent you can:
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Eliminate manual steps:
Automatically check existing authorizations, collect documentation, and manage complex payer rules.
- Streamline data entry: Automate the entry of patient demographics, CPT codes, provider details, and health plan information directly into TRICARE.
- Minimize errors & boost consistency: Intervene only when necessary, cutting turnaround times, ensuring compliance, and accelerating test scheduling.
Patient Access Plus integrates seamlessly via API and RPA with other TPAs—including Cohere, Cigna Ash, Optum, and more—to automate prior authorizations across diverse payers.
HOW IT WORKS
An automated solution for prior auth submission and monitoring
Once a prior authorization request is ready, our attended automation agent takes over the initiation process. Here’s how it works:
Patient Access Plus triggers automation agent
When an initiation request is sent to Patient Access Plus from the client LIS system, the automation agent logs into TRICARE’s payer portal and begins entering the necessary patient, test, and ordering provider details—without the need for manual action.
The automation agent interacts with TRICARE's portal
The agent completes all required steps in the initiation process—logging into the portal, selecting the appropriate test codes, submitting forms, and answering questions.
Human intervention only when truly necessary
If the automation agent encounters an unexpected requirement—such as missing clinical documentation from the ordering provider or payer-specific questions—it pauses and notifies a user to intervene. The user can quickly provide the information and resume the automation without restarting the process.
Authorization status updates in your system
Once the request is submitted, the automation agent captures the response and updates the authorization status within your LIS. This ensures your team has real-time visibility into every request.
By automating the initiation process with TRICARE, our solution helps labs reduce delays, minimize errors, and manage high volumes of prior authorizations more efficiently—allowing your staff to focus on patient care and more complex tasks.
