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Description
Compatibility Level
Clients
Product Capabilities
Use cases
EHR integrations
Client types
Awards
Differentiators
Keywords
Media
Company details
Jump to:
Categories
Solutions
Description
Compatibility Level
Clients
Product Capabilities
Use cases
EHR integrations
Client types
Awards
Differentiators
Keywords
Media
Company details
Digital Clinical Assistant (DCA)
Digital Clinical Assistant (DCA)

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Categories

Solutions

Description

Product Description:

The Digital Clinical Assistant is your solution to the prior authorization process. The Digital Clinical Assistant leverages innovative AI technology and a digital workforce to automate the burdensome process within Athenahealth EHR- eliminating the need to learn new tech or add to existing workflows. As a result, the DCA can improve the time to approval by up to 50%, increasing the number of approvals you can process daily. In addition, the DCA can reduce the cost of prior authorization by up to 60% and alleviate the administrative burden on your staff.

About Digital Blue:

Digital Blue is a healthcare consulting and solutions company focused on improving lives through optimized business performance. Our services and solutions empower leaders across the healthcare ecosystem to eliminate inefficiencies, increase productivity and improve patient satisfaction. Client benefits include; increased revenue, reduced operational cost and administrative burden, and improved quality of care. 

Product Description:

Agentic AI employees for healthcare

Explore our custom AI employees for critical back office, revenue cycle, and administrative healthcare workflows. Some of our most popular include full automations for:

  1. Prior authorizations
  2. Claims processing
  3. Insurance verification
  4. Payment posting
  5. Patient enrollment
  6. Denial management
  7. Claim scrubbing
  8. Credentialing
  9. Charge reconciliation

How Magical works

Fully automate rev cycle workflows

Use an AI employee trained specifically in revenue cycle management to automate entire processes end-to-end. (No human oversight required.)

Lower your cost to collect

Unlock the efficiency of a machine. Magical pulls patient patient data directly from one system into another, to minimize insurance denials and delays.

Built for enterprise security

Maintain the highest levels of security and privacy. We never store any personal health info on our servers. 

Daily Automated Testing | Automation Logs | SOC2 & HIPAA Compliant

Best-in-class reliability

Get over 90% success rates on end-to-end automations of any complex workflow. Magical uses multi-agent evaluation infrastructure to ensure your automations are running smoothly. 

Performance monitoring

Dive into complete logs of every single step of every single automation to give your team clear visibility into success rates and edge cases. 

Who we are

A blended team of 40+ technology and healthcare experts. Not only will you be working with agentic AI engineers, but also seasoned rev cycle experts. 

Why we’re trusted

Over 100,000+ companies—including WebPT, Phreesia, SonderMind, and Curalta—trust Magical automations for the following reasons:

  1. Fast: 1 month average implementation time
  2. Reliable: 90%+ average success rate end-to-end
  3. Proven: 100% agentic automation (no bots)
  4. Scalable: Magical runs entirely on virtual machines
  5. Interoperable: Magical can rapidly integrate with any system
  6. Compliant: Magical is SOC 2 and HIPAA-compliant
About Magical:

Magical is an agentic AI platform that fully automates complex workflows in just one week. Put your back office on autopilot with AI employees that use human-like decision-making and best-in-class reliability. 

Who we are

A blended team of 40+ technology and healthcare experts. Not only will you be working with agentic AI engineers, but also seasoned rev cycle experts. 

Why we’re trusted

Over 100,000+ companies—including WebPT, Phreesia, SonderMind, and Curalta—trust Magical automations for three key reasons:

  1. Fast: 1 week average implementation time
  2. Reliable: 90%+ average success rate end-to-end
  3. Proven: 100% agentic automation (no bots)

About the technology

Fully agentic

Magical AI agents use reasoning models, real- time data retrieval, and goal-based execution to make your automations more reliable than traditional rule-based approaches. They can adapt to changes on the fly, and learn from failures. 

Best-in-class reliability

Get over 90% success rates on end-to-end automations of any complex workflow. Magical uses multi-agent evaluation infrastructure to ensure your automations are running smoothly. 

Performance monitoring

Dive into complete logs of every single step of every single automation to give your team clear visibility into success rates and edge cases. 

Scalable

Magical runs entirely on virtual machines

Interoperable

Magical can rapidly integrate with any system

Compliant

Magical is SOC 2 and HIPAA-compliant

Compatibility level

Select which hospital or health system you work at and see a personalized compatibility level.

Clients

Select which hospital or health system you work at and see the client list

Product Capabilities

The DCA will gather all information from the open prior auth request, including reading the ePA portal key from faxes or digital documents attached to the prior auth request. The DCA uses APIs to retrieve data such as demographics, lab results, and medication history. The DCA executes business rules and submits the initial request in the provider's configured workflow. The DCA also updates internal notes with the ePA key, making navigation between ePA portal and the EMR easier

Prior authorization requirements knowledge base is continually and automatically maintained with minimal effort required outside of the clinical team outside of weekly check-ins to verify all clinical questions are being answered as they would (continuous quality improvement).

The digital worker entirely automates form completion via API access. Appropriate fields are populated by leveraging structured and unstructured data from the EHR.

DCA and its components are a secure, Microsoft Azure Cloud-based infrastructure.

Necessary documentation can be attached to satisy the prior authorization request via APIs

Prior authorization requests can be submitted on behalf of the health system through e-fax, payer portals, their party sites, etc.

Prior authorization request status is monitored in near real-time. It can be pushed back, along with other relevant information (e.g., tracking numbers, supporting text), into the appropriate work queues and fields within the EHR. Exceptions-Only processing is done by the clinician - ie: only clinical questions the the DCA is not configured for will be sent back to the clinical team.

Make your workflow automations self-driving Traditional automations (RPA) is rigid and fragile, like driving manually to a destination using printed directions. If you miss a turn or make an error, everything quickly breaks. Agentic AI is like a self-driving car that understands your goal and the nuance it takes to get there. This is intelligent automation that course-corrects, identifies shortcuts, and gets smarter over time.

Magical is SOC 2 and HIPAA-compliant

Verify patient insurance in seconds—not hours—with your new AI employee for eligibility and benefits verification. Fully automated verifications Magical AI employees log into payer portals, search for patient eligibility, and pull coverage details—automatically and accurately. Real-time benefit checks Automatically verify deductibles, co-pays, and plan-specific benefits so your team is never in the dark. Catch problems before they become denials Identify inactive policies or mismatched details upfront, so you can fix issues before submitting claims.

Identify, fix, and resubmit denied claims—automatically—with an AI employee that never misses a deadline or a denial reason. Auto-identify denials at scale Magical reviews ERAs, EOBs, and payer responses to flag and categorize denials in real time. Fix root-cause errors instantly Whether it’s a coding mismatch, missing modifier, or eligibility issue—Magical uses context-aware logic to correct and prepare clean resubmissions. Automate appeals and resubmissions Magical navigates payer portals, fills out appeal forms, and resubmits claims—without human input.

Set up an AI employee to automatically monitor the status of all prior authorizations and keep them up-to-date.

Use an AI employee to verify all information and flag any potential errors for human review. If the request looks clean, you can enable your AI employee to automatically submit it.

Automatically open and extract information from any PDF or patient file, as part of the overall workflow automation process.

Use an AI employee to automatically complete forms more reliably than any RPA bot. Get pixel-perfect precision in any EMR or insurance portal, as well as independent AI judges to verify successful form completions.

Eliminate manual data entry and reduce denials by over 50% with your new AI employee that specializes in prior authorizations. Automate prior auths end-to-end using AI Magical reliably moves patient information from your EHR and submits directly into insurance portals and prior authorization systems. Export information to any authorization form Magical recognizes information on insurance portals and automatically maps it to the right fields, getting smarter over time. Human-in-the-Loop Verification Magical combines AI automation with human verification to maintain complete accuracy and compliance in your prior authorization process.

Use Cases

Description:

The Challenge

  • Prior authorization is the most burdensome process for many providers
  • The number of procedures, drugs & DME requiring prior authorization continues to grow
  • Payers, providers, and CMS do not utilize common prior-authorization rules, standards, documentation, or processes –this causes up to 80% of initial prior authorization denials
  • Manual prior authorization processes are getting costlier due to additional administrative burdens.
  • Many delays in patient care are directly related to prior authorization delays and data entry errors, resulting in risk to the patient and questions from them and their families.

The Solution

  • Centralized prior authorization work-bench with optimized workflows, case tracking, and reporting
  • Automated retrieval of the most up-to-date formularies and prior auth guidance by payers
  • Automated gathering of disparate data and documents for consolidation and initial fulfillment of prior authorization requests
  • Real-time, intelligent notifications and tasking for prior authorization team to ensure efficient exception processing
  • Built-in assistance for prior authorization nurses through the centralized workbench
  • Exception-only involvement of prior authorization team, guiding to improve the initial prior authorization submittal process in the future.

The Benefits

  • Reduce prior authorization costs by up to 60%
  • Reduce the decision time on prior authorizations by up to 50%
  • Provide hundreds of hours per year back to nurses to provide quality care, as opposed to prior authorization administrative tasks
  • Increase the rate of first-pass approval of prior authorizations by up to 50%
  • Decrease patient’s likelihood of abandoning care due to frustration or inconvenience
  • Retain the familiarity of your EMR for physicians while streamlining the process for nurses
  • The DCA requires no changes to your existing EMR system
Pediatric use cases:

No modifications to the workflow are necessary for pediatrics

Users:

FQHCs, Primary Care, Mult-Specialty Physician Groups, Hospital Clinics, Physician Groups, Medical Group Practices, Independent Medical Practices, Telehealth providers, Ambulatory Surgery Centers, Urgent Care Centers, Hospitals, Pediatricians, Dermatologists, Endocrinologists, Gastroenterologists, Cardiologists, OBGYN, Community Health Centers, Rural Hospitals, Non-Profit Hospitals, Specialty Group Practices.

Description:

Automate complex healthcare operations workflows end-to-end using agentic AI.

Magical deploys specialized AI employees that complete high-volume administrative and revenue cycle tasks across systems — including prior authorizations, referrals, eligibility, benefits verification, claims follow-up, and data reconciliation — with built-in quality controls and human review when needed.

Teams go live in weeks (not months) and achieve 90%+ straight-through automation with perfect accuracy on completed work.

Pediatric use cases:

None provided

Users:
  • Healthcare operations executives (CFO, COO, VP Ops)
  • RCM leaders and managers
  • Prior authorization specialists
  • Referral and intake teams
  • Billing and claims operations staff
  • Payment integrity and denial management teams

EHR Integrations

Integrations:

Ambulatory EMR, Patient portal

EMR Integration & Relevant Hardware:

Use case dependent

EMRs Supported:

athena

Hardware Compatibility:

Not applicable

Integrations:

Acute care EMR, Ambulatory EMR, Ancillary EMR, ERP system, Patient portal, Pop health platform, Home health, Behavioral health, Community based organizations, ADT, Access +/or revenue cycle, Credentialing, Website / public online sources, Other

EMR Integration & Relevant Hardware:

Use case dependent

EMRs Supported:

Epic, Cerner, Meditech, Allscripts, NextGen, athena, GE, eClinicalWorks, McKesson, Other, Allscripts/Eclipsys, Athenahealth, Azalea Health/Prognosis, CPSI, Evident, Healthland, MEDHOST, MedWorx, QuadraMed, Self-developed, Would prefer not to disclose, Point Click Care

Hardware Compatibility:

Desktop

Client Types

None provided

Awards

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Differentiators

Differentiators vs EHR Functionality:

Prior Auth Process As-Is

Prescriber opens the EMR and prescribes the prescription.

The pharmacy will notify the prescriber that a prior auth is needed

Prescriber will submit an electronic request for prior authorization through ePA or insurance portals

Prescribers and their staff input patient demographic information and history and answer clinical questions as they come in. 

The staff is constantly checking for status updates

Duplicate requests come in, typically at night and over the weekend. If the PA request isn't completed quickly enough, these must be filtered out manually.

Backlogged workbaskets and data-entry errors cause care gaps and delays in treatment.

Increased administrative burden is the number one cause in provider burnout and a significant cause for loss in revenue

DCA Optimized Prior Auth Process

The Clinician Opens the EMR and prescribes the medication

DCA monitors the EMR and other systems for PA work and kicks off the automated process

DCA auto-triages PAs and removes ALL duplicate requests as they come in

DCA auto-fills forms via APIs and submits the requests for medications it has been configured for based on your practices' volumes

DCA creates a work queue for any encountered exceptions

nurses work only the PA requests or clinical questions that the DCA is not configured for, saving time for high-value work

Based on payer rules, the DCA posts status updates/tasks to EMR and auto-updates status

60% reduction in manual effort

50% improvement in time to approval

100% elimination of duplicate requests

See more patients, improve employee satisfaction/retention, and get home on time!

Differentiators vs Competitors:

None provided

Differentiators vs EHR Functionality:

• Works across systems — not inside just one EHR

Magical automates workflows that span EHRs, payer portals, fax, email, and external tools — where most operational work actually happens.

• Completes work, not just routes it

Unlike EHR task queues and rules, Magical’s AI employees perform the full workflow end-to-end (data gathering, form completion, submission, follow-up, and reconciliation).

• Built for real-world variability

Handles unstructured data, changing payer rules, and edge cases that EHR automations can’t manage reliably.

• Rapid deployment without IT backlog

Go live in weeks with workflow-first AI — no heavy integrations, scripting, or custom development.

• Built-in quality controls & audit trails

Every action is logged, reviewable, and governed for healthcare compliance.

Differentiators vs Competitors:

• True agentic AI — not scripts or fragile bots

Magical deploys specialized AI employees that reason, adapt, and complete workflows — not brittle RPA or single-step automations.

• End-to-end ownership of outcomes

From intake to resolution, Magical automates the full process instead of isolated tasks.

• Proven at enterprise scale

Live in production across high-volume healthcare operations with 90%+ straight-through automation.

• Workflow-first design

Built specifically for healthcare operations and revenue cycle — not generic automation retrofitted to healthcare.

• Fast time to value

Customers go live in weeks and see ROI immediately — not months of implementation and tuning.

Keywords

Images

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Videos

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Downloads

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Company Details

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