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.

Our single platform approach provides immediate visibility into revenue cycle opportunities, tackling some of today's biggest challenges with the following Productized Analytics Suite Modules:

• Workforce Quality Insights (WQI) – Links front-office actions to financial KPIs
• Patient Access Insights (PAI) – Enhances financial experience pre-service
• Revenue Integrity Suite (RI) – Reduces denials and compliance risks
• Productivity Analytics (PA) – Improves staff productivity in real-time
• Cost Insights (CI) – Targets controllable costs
• Business Office Suite (BOS) – Unifies patient accounting data

Founded in 1993, MedeAnalytics is an innovation-focused company. Over the past three decades, we have worked tirelessly to reimagine healthcare through the power of data—and helped thousands of organizations achieve their potential along the way.

Leveraging state-of-the-art analytics and data activation, MedeAnalytics delivers actionable insights that support payers, providers, employers, and public entities as they navigate the complex healthcare landscape.

Using artificial intelligence and machine learning alongside the most advanced data orchestration in the industry, we empower organizations to optimize their resource allocation, experience superior patient outcomes, and achieve population health management goals.

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.

• Detailed and summary level reporting for different views to serve multiple purposes; 
• Standard and ad-hoc reporting allowing clients flexibility to slice/dice based on unique corporate needs;
• Incorporation of MedeAchieve across entire RCM portfolio to incorporate metric tracking into key enterprise initiative tracking;
• Worklisting available throughout the RCM workflow;
• Vendor flexibility – Plug & play any vendor into existing Mede workflows;
• Robust rules engine to drive efficiencies and streamline workflows;
• Integration of AI Agents to streamline and reduce manual entry;
• Predictive analytics using AI intelligence;
• Focus on productivity analytics to highlight and stratify registrar performance;
• Integrated Financial Clearance Workflows to maximize revenue generation

Enterprise Analytics - MedeAnalytics helps users identify key outliers in their data and distribute the right actionable information to the right people – at the right level – throughout the enterprise. 

MedeAnalytics can measure revenue and practice performance across the entire system. Our approach to organizing data into a patient longitudinal record has led to improved financial, operational, and even clinical performance.

Our Integrated MedeAchieve solution improves strategy execution with action plans that define your objectives, align staff around shared goals, and track progress in a closed­ loop system.