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Jump to:
Categories
Solutions
Description
Compatibility Level
Clients
Use cases
EHR integrations
Client types
Differentiators
Keywords
Media
Company details
Fathom
Fathom

0 review

Prior Authorization
Prior Authorization

0 review

Categories

Solutions

Description

Product Description:

Fathom is an autonomous medical coding platform that provides accurate, complete, touchless coding for ICD, CPT/HCPCS, E/M, modifiers, provider assignment, units, shared services, deficiencies, and all other required coding elements across specialties. With Fathom, providers benefit from:

  • 90%+ successful automation rates: Of all patient encounters provided to Fathom for coding, around 90% or more are successfully coded autonomously or correctly flagged for documentation deficiencies.
  • 96%+ accuracy rates: Ongoing audit programs ensure greater-than-human coding accuracy.
  • 30-50% cost savings: Fathom delivers an average 42.3% reduced cost to code.
  • Denials reduction: Stronger accuracy and immediate flagging of documentation deficiencies fix coding errors upstream and reduce denials.
  • RVU increase: Through higher coding accuracy, especially on E/Ms, Fathom typically results in a meaningful improvement to revenue capture.
  • Lightning-fast turnarounds: Fathom typically returns complete coding results for the day's encounters within 2 hours, averaging 57 min.
  • Industry-leading SLAs: Contractual commitments to guarantee performance for automation, accuracy, turnaround time, and other metrics.

Through a risk-free trial, Fathom enables providers to validate our coding quality for themselves before turning on production-ready models upon go-live. In production, Fathom receives clinical documentation from EMRs following patient visits, fully codes the encounters according to guidelines and payer rules, and returns complete coding results for claim submission. This consistent application of coding guidelines improves outcomes and enables enterprise-wide compliance.

About Fathom:

Fathom is an autonomous medical coding platform that uses deep learning and LLMs to provide accurate, complete coding for E/M, CPT/HCPCS, ICD, provider assignment, deficiencies, and other coding elements across specialties.

Product Description:
Magical’s Prior Authorization Agent is an advanced agentic AI solution purpose-built to automate the full prior authorization workflow—reducing delays, manual effort, and denials that burden providers and revenue cycle teams. Designed to act like a digital employee, the solution intelligently extracts clinical documentation from EMRs, determines the appropriate payer-specific requirements, completes the necessary forms, and submits them through the correct channels, whether by API, portal, or fax. Unlike traditional automation tools that rely on static rules or templates, Magical’s agentic AI operates with reasoning and adaptability. It can navigate unstructured systems, manage edge cases, and respond to real-time payer feedback without requiring human oversight. Once submitted, the agent continuously monitors the status of each request, follows up as needed, and flags any denials or exceptions that may require staff intervention. The result is a dramatic improvement in operational efficiency and patient access to care. Organizations using Magical’s Prior Authorization Agent have seen faster turnaround times, reduced administrative burden, and improved clean submission rates. By automating repetitive and error-prone tasks, it frees staff to focus on higher-value work and enhances the patient experience. Magical’s Prior Authorization Agent is easy to deploy, EMR-agnostic, and scalable across service lines. It brings together powerful AI, healthcare-specific workflows, and continuous learning to deliver consistent results in even the most complex payer environments. Whether your goal is to reduce cost, speed up access, or improve accuracy, Magical delivers automation that thinks, acts, and delivers—like your best employee, 24/7.
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

Use Cases

Description:

Fathom is an autonomous medical coding platform that provides accurate, complete, touchless coding for ICD, CPT/HCPCS, E/M, modifiers, provider assignment, units, shared services, deficiencies, and all other required coding elements across specialties. With Fathom, providers benefit from:

  • 90%+ successful automation rates: Of all patient encounters provided to Fathom for coding, around 90% or more are successfully coded autonomously or correctly flagged for documentation deficiencies.
  • 96%+ accuracy rates: Ongoing audit programs ensure greater-than-human coding accuracy.
  • 30-50% cost savings: Fathom delivers an average 42.3% reduced cost to code.
  • Denials reduction: Stronger accuracy and immediate flagging of documentation deficiencies fix coding errors upstream and reduce denials.
  • RVU increase: Through higher coding accuracy, especially on E/Ms, Fathom typically results in a meaningful improvement to revenue capture.
  • Lightning-fast turnarounds: Fathom typically returns complete coding results for the day's encounters within 2 hours, averaging 57 min.
  • Industry-leading SLAs: Contractual commitments to guarantee performance for automation, accuracy, turnaround time, and other metrics.

Through a risk-free trial, Fathom enables providers to validate our coding quality for themselves before turning on production-ready models upon go-live. In production, Fathom receives clinical documentation from EMRs following patient visits, fully codes the encounters according to guidelines and payer rules, and returns complete coding results for claim submission. This consistent application of coding guidelines improves outcomes and enables enterprise-wide compliance.

Pediatric use cases:

None provided

Users:

Health systems, hospitals, physician groups, ambulatory providers, risk-bearing providers, health plans, and other organizations.

Description:

None provided

Pediatric use cases:

None provided

Users:

None provided

EHR Integrations

Integrations:

Acute care EMR, Ambulatory EMR, Ancillary EMR, Pop health platform, Home health

EMR Integration & Relevant Hardware:

Use case dependent

EMRs Supported:

Epic, Cerner, Meditech, Allscripts, NextGen, athena, eClinicalWorks, Athenahealth, MEDHOST, Self-developed

Hardware Compatibility:

Not applicable

Integrations:

None provided

EMR Integration & Relevant Hardware:

None provided

EMRs Supported:

None provided

Hardware Compatibility:

None provided

Client Types

Differentiators

Differentiators vs EHR Functionality:

None provided

Differentiators vs Competitors:

None provided

Differentiators vs EHR Functionality:

None provided

Differentiators vs Competitors:

None provided

Keywords

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Fathom is a medical coding AI

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Company Details

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