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

Categories

Solutions

Description

Product Description:

Prior authorization remains one of the most time consuming and error prone processes in healthcare operations. Manual checks, incomplete documentation, payer specific rules, and delayed follow ups often result in denials, treatment delays, and administrative overload.

Droidal Prior Authorization AI Agent addresses these challenges by automating the full authorization workflow. The AI Agent reviews insurance and payer rules to determine authorization requirements, pulls relevant clinical documentation from EHR systems, and prepares complete, payer ready submissions. Requests are submitted in real time and continuously monitored for updates or missing information.

The solution keeps care and revenue cycle teams informed through timely alerts and system updates. If a request is denied, the AI Agent assists with appeal preparation and resubmission to speed up resolution. By reducing manual effort and improving accuracy, healthcare organizations can process authorizations faster, lower denial rates, and ensure patients receive timely access to care.

About Droidal LLC:

Droidal gives healthcare organizations a powerful advantage by offering more than 20+ AI agents that support the entire RCM process from start to finish. These agents handle insurance checks, claims, denials, Prior authorizations, and patient intake, helping teams reduce manual work and maintain smooth daily operations. With accurate data processing, cleaner claims, and faster follow-ups, organizations experience quicker reimbursements and stronger financial stability. Droidal works seamlessly with existing EHR systems, improves compliance, reduces denial risks, and ensures consistent performance even during staffing shortages. This allows healthcare organizations to achieve reliable revenue cycle results while focusing more on patient care.

Product Description:

This solution automates the process of checking requests under review as well as continued status changes and updates. It supports many portals such as Evicore, Magellan, UHC and others. The solution includes business rules, exception handling and daily reporting functionality with customizable dashboard views. AI is also used to do analysis and supply predictive capabilities. The solution can also be hosted and supported by CampTek as an ongoing managed service.

About CampTek Software:

CampTek Software is a Full-Life-Cycle Intelligent Automation/AI SaaS Provider with proven results implementing and supporting automation solutions through our successful methodology. Our unique hosted model offers many powerful advantages including a shorter time to market, 24/7 support and overall lower cost of entry. Our approach is simple, scalable and repeatable.

CampTek will be with you on every step of your RPA & AI Journey!

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:

High-Volume Requests: Manages large numbers of prior authorization requests efficiently.

Pre-Service Checks: Confirms authorization needs before scheduling care.

Payer Submissions: Prepares and submits requests to payers accurately.

Status Tracking: Monitors authorization progress and flags delays.

Denials and Appeals: Supports review and appeal of denied requests.

Multi-Payer Workflows: Handles varying payer rules across specialties.

Pediatric use cases:

None provided

Users:
  1. Hospitals and health systems
  2. Specialty and multi-specialty clinics
  3. Revenue cycle management organizations
  4. Ambulatory care centers
  5. Managed service organizations
  6. Billing companies
Description:

Industries: Healthcare, RCM

Provider Systems: Epic

Payer Portals: eviCore, United Healthcare, Magellan

Challenge

A large healthcare provider needed to ramp up their automation strategy to offset labor instability and attrition. Currently the staff manually have to go out to payer portals, submit requests and check statuses of Prior Authorizations, sometimes multiple times. Through Task Mining AI (Artificial Intelligence) analysis, it was determined that staff were spending about 30 – 40% of their time submitting requests and checking the status for 19,000 prior authorizations per month.

Prior Authorization Requests: 3 bots processing prior authorization requests in 3 separate portals (EviCore, Magellan and UHC).

  • EviCore: 923 transactions per month
  • Magellan: 595 transactions per month
  • UHC: 7,063 transactions per month

Prior Authorization Statusing: 3 bots processing prior authorization statuses in 3 separate portals (EviCore, Magellan and UHC).

  • EviCore: 5,536 transactions per month
  • Magellan: 3,572 transactions per month
  • UHC: 986 transactions per month

 

Solution:

RPA bots are a much more accurate and effective solution to verify the status of patient health authorizations, RPA bots can repeatedly check requests under review for status changes and updates.

CampTek Software was engaged because of its healthcare and Epic experience. Through task mining, AI models were created, and results were reported back to the customer with enormous success. The next phase of design and build all occurred in a brief time. The bot now in production includes business rules, exception handling and daily reporting functionality. It is also supported by CampTek as an ongoing managed service solution for the provider.

The Bot is now saving 2,696 FTE (full-time employees) hours per month or 32,352 hours (about 3 and a half years) per year. The FTE capacity gain is 17 FTEs (full-time employees), and the ROI (Return on Investment) is $1,085,000 per year.

Pediatric use cases:

None provided

Users:

Any healthcare provider

EHR Integrations

Integrations:

Acute care EMR, Ambulatory EMR, Ancillary EMR, ERP system, Patient portal, Home health, Behavioral health, Community based organizations, Access +/or revenue cycle, Credentialing, 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:

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:

None provided

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:

None provided

Client Types

None provided

Awards

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Differentiators

Differentiators vs EHR Functionality:

Purpose-Built for Prior Authorization: Designed specifically to manage the full prior authorization process, beyond basic EHR capabilities.

Active Status Tracking: Provides ongoing visibility and follow ups after submission, not just static status updates.

Payer-Specific Handling: Adapts to individual payer rules and documentation needs, unlike generic EHR workflows.

Denials and Appeals Support: Assists with denial review and appeal preparation, which most EHRs do not cover.

Scales Beyond EHR Limits: Handles higher volumes and multiple specialties without being constrained by EHR configurations.

Differentiators vs Competitors:

End-to-End Prior Authorization Focus: Built specifically to manage the full prior authorization lifecycle, not a partial workflow or add-on feature.

Real Time Status Visibility: Provides continuous tracking and clear updates, reducing the need for manual checks and follow ups.

Payer-Aware Workflows: Aligns with payer-specific rules and documentation requirements rather than relying on generic processes.

Denial and Appeal Support: Helps teams address denials and prepare appeals, which many competing tools leave manual.

Designed for Scale: Handles high authorization volumes across multiple specialties without performance drop-offs.

Fits Into Existing Systems: Works alongside current EHR and RCM platforms without forcing workflow replacement.

Differentiators vs EHR Functionality:

We offer Intelligent Automation as a Managed Service and have successfully built automations for every major EHR.

Differentiators vs Competitors:

We not only focus on development but also full support of bots once they are in production. Each bot has its own custom dashboard view so that our customers are continuously informed of its daily trransaction metrics and KPIs.

Keywords

Images

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Droidal Prior Authorization AI Agent

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Videos

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Prior Authorization Request: EviCore

Downloads

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Revenue Cycle Prior Authorization Case Study

Alternatives

Company Details

Founded in 2018

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