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.

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.

There is a different way to work. If you were to reimagine the way you run your business, what would you do differently? What if you could save up to 80% of your operational costs by reimagining the way business outcomes are delivered?

Through the power of automation emerging technologies, we challenge you to think differently about how you work and how you use your people to full effective.

We can help you across the automation journey from thinking through your strategy to implementing and executing robotic process automation, machine learning and other emerging technologies across the enterprise.  

Revenue Cycle Management:

Prior Authorization ​

Insurance Claims - Posting

Patient Payment - Posting

Coordination of Benefits: Primary, Secondary, & Tertiary

Revenue Integrity - Payment Audits (Under & Over)

Provider: Insurance Enrollment

Revenue Integrity - Charge Description Master (CDM) Management

Revenue Integrity - IME or IMR Audits (CMS & Medicare Advantage)

Insurance Claims - Denied & Rejected Follow-Up

TQA Healthcare enables healthcare and life sciences organizations to transform the patient experience and reduce costs through increased personalization, intelligent automation, and AI. 

The practice’s solutions impact patient access, the revenue cycle, order processing, and clinical needs at the most critical stages of the patient journey, resulting in a seamless encounter.

By empowering individuals to actively manage their unique experiences, TQA Healthcare increases the satisfaction of every healthcare consumer: patients, staff, and clinicians.

Houston-based, TQA Healthcare is formerly Element Blue. 

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.

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.

While EHRs offers integration tools, achieving seamless data exchange, particularly with non-EHR systems, can be challenging due to their limited interoperability.

This can create communication hurdles between providers using different EHRs, healthcare facilities not on a particular EHR, and providers who need to integrate with other advanced technology platforms outside of the EHR ecosystem.

TQA's solutions can integrate with any platform and are independent of particular products or technologies. This affords our teams unlimited creativity when ideating custom solutions for each healthcare organization.

TQA has a practice that is dedicated exclusively to healthcare and life sciences. This is unique among our UiPath competitors, who serve multiple industry verticals.

A UiPath Platinum partner, TQA is recognized as a leading systems integrator with more than 20 years' experience in working with some of the world's best known providers, payers, diagnostics, and life sciences organizations.