Prior authorisation cleared in hours, not days — under full audit.

Prior-auth backlogs delayed care and buried staff in paperwork. Each request touched several systems, and every step had to be defensible to auditors and payers.

We deployed agents under scoped identities to assemble the clinical and eligibility data, validate against payer rules, and submit — escalating genuine edge cases to a nurse reviewer with the full record attached. Nothing an agent did was outside the audit trail.

Turnaround dropped from days to hours on routine authorisations, staff moved to the complex cases, and compliance reviews became a query against the log rather than a fire drill.