Automate prior auth, claims processing, and eligibility verification to accelerate revenue
AI-powered workflows that handle prior authorization submissions, claims status tracking, eligibility checks, and denial management — reducing days in A/R and freeing revenue cycle staff.
Built for Revenue Cycle Leaders, Billing Ops & Practice Managers
The Problem
Why manual triage doesn't scale
Prior Auth is a Manual Nightmare
Staff spend hours per authorization calling payers, filling out forms, and chasing approvals — delaying patient care and consuming revenue cycle resources.
34% of physicians report care delays due to prior auth
Claim Denials Erode Revenue
Initial claim denial rates continue to climb. Each denied claim costs $25-$118 to rework, and many are never resubmitted.
Average initial claim denial rate: 10-15%
Slow Eligibility Verification
Verifying patient insurance eligibility and benefits manually at each visit creates bottlenecks and surprises at the point of care.
Days in A/R Keep Climbing
Manual claims processing extends days in accounts receivable, tying up cash flow and increasing the cost to collect.
Average days in A/R: 45-55 days for many health systems
Results
Measurable impact from day one
70%
Faster Prior Auth
Automated submission and follow-up cut prior authorization turnaround from days to hours.
45%
Fewer Claim Denials
Pre-submission validation catches errors and missing information before claims are filed.
30%
Reduction in Days in A/R
Automated claims tracking and follow-up accelerate reimbursement and improve cash flow.
5x
Staff Throughput
Revenue cycle staff handle more authorizations and claims with AI-assisted workflows.
Capabilities
Everything you need for intelligent triage
Automated Prior Authorization
AI prepares and submits prior authorization requests to payers with required clinical documentation and follows up automatically.
- Payer-specific form auto-population
- Clinical documentation attachment and compilation
- Automated status tracking and follow-up
Real-Time Eligibility Engine
Verify patient insurance eligibility, benefits, and co-pay in real time at scheduling, registration, and point of care.
- Batch and real-time eligibility verification
- Benefits and co-pay estimation for patients
- Coverage gap detection and notification
Denial Prevention & Management
AI analyzes claims before submission to catch errors, and automates denial follow-up and appeals for rejected claims.
- Pre-submission claim scrubbing and validation
- Denial root cause analysis and trending
- Automated appeal letter generation
Revenue Cycle Analytics
Dashboards tracking authorization turnaround, denial rates, days in A/R, and payer performance across your organization.
- Payer-level performance scorecards
- Denial trending by category and payer
- Staff productivity and throughput metrics
How It Works
Three steps to automated triage
Step 1
Verify & Authorize
Patient eligibility is verified in real time. Prior authorization requests are auto-generated with clinical documentation and submitted to payers.
Step 2
Submit & Validate
Claims are scrubbed for errors, validated against payer rules, and submitted electronically. AI flags issues before they become denials.
Step 3
Track & Recover
Automated follow-up on pending authorizations and unpaid claims. Denials are appealed with AI-generated documentation.
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Frequently asked questions
How long does prior authorization take with FlowGenX?
Around 70% faster than a manual process. The agent checks payer requirements, assembles the clinical documentation, submits through the payer's channel, and tracks status — so staff handle the exceptions rather than filling in portals and waiting on hold for status updates.
How does automation reduce claim denials?
Denials are mostly preventable data problems — eligibility, coding, missing authorization. Each is validated before submission rather than discovered weeks later, cutting denials by roughly 45%. The denials that still occur are triaged and worked automatically instead of ageing in a worklist.
What impact does this have on days in A/R?
Typically a 30% reduction. Faster authorization, cleaner first submissions, and automated denial follow-up each remove waiting time from the cycle rather than compressing work at a single stage. Revenue cycle staff throughput rises roughly fivefold once routine portal work stops consuming the working day.
Related Glossary Terms
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