Solutions · Prior Auth Autopilot

PA packets in 60 seconds. Submitted across portal, fax, and phone.

Adentris pulls diagnosis, level of care, treatment plan, and medical necessity from the EHR. Generates payer-ready packets. Submits via the channel each payer prefers. Tracks every peer-to-peer window.

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30 min → 60 sec From clinician/UR time to draft-ready packet, customer-validated.
The problem

Prior auth is the single largest administrative tax on care delivery.

CMS-0057-F kicks SLAs in January 2026. Most networks are not ready.
41 hrs / wk Physician and staff time spent on PA per practice, on average. 88% of physicians call PA burden "high or extremely high." AMA Prior Authorization Physician Survey, 2024
94% Of physicians report PA-related delays to medically necessary care. AMA, 2024
72 hours CMS-0057-F mandated decision SLA for urgent PAs starting January 2026. Standard PA: 7 days. CMS Final Rule CMS-0057-F
How it works

Generate, submit, track, escalate. One queue.

From scheduled service to approved authorization, with the audit trail CMS will ask for.
01

Read the chart

Agent pulls diagnosis, level of care, treatment plan, ASAM level for BH, conservative-care notes, and supporting results from the EHR.

02

Generate the packet

Medical necessity narrative tailored to the payer's medical policy. CPT/HCPCS, ICD-10, attachments. Reviewer-approval queue before submission.

03

Submit any channel

Payer portal (Availity, NaviNet), fax, or phone. Channel selected by payer preference. Status tracked in one queue regardless.

04

Track to decision

Real-time status. Peer-to-peer windows surfaced with countdown. SLA breach alerts. Full electronic decision log per CMS-0057-F.

What you get

Less staff time. Fewer missed windows. Faster approvals.

60 sec Packet generation, down from 20–30 minutes per PA.
100% Channel coverage: portal, fax, and phone in one queue.
~80% Reduction in missed peer-to-peer windows, customer-validated.
CMS-0057-F SLA-ready audit trail with every electronic decision logged.
Adentris fundamentally changed how we approach documentation quality and compliance oversight. Instead of discovering problems weeks later during audits or payer reviews, our team can identify and address issues proactively as part of everyday operations. I can't imagine going back to the old way.
Rebecca Legov
Rebecca Legov
COO, Resilient Recovery Treatment
Side by side

Adentris vs the alternatives.

Manual PA is the status quo. Other PA tools are payer-side or partner-dependent. Adentris is provider-side and works on any EHR, with or without an API.
Capability
Adentris
Manual PA
Other PA tools
Packet generation
60 seconds, chart-cited
20–30 min per PA
Template-based, payer-dependent
Submission channels
Portal + fax + phone, one queue
Portal only, or fax-by-hand
Portal-only, payer-by-payer
Peer-to-peer tracking
Real-time countdown, payer-specific windows
Spreadsheet or memory
Limited or none
EHR integration
API, FHIR, HL7, or AI agents · any EHR, live in 60 days
Staff logs in manually
API or partner-dependent, multi-month project
CMS-0057-F audit trail
Every decision logged, exportable
Manual log, gap-prone
Partial, per integration
Prior auth FAQ

Common questions.

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01 How does this meet the CMS 2026 SLA requirements?

The CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) requires 72-hour SLAs for urgent PAs and 7-day SLAs for standard, with full electronic decision-tracking. Adentris generates PA packets on demand, tracks submission timestamps, and surfaces every payer response with the original electronic decision so your team has the audit trail when CMS asks.

02 Which channels does it submit through?

Payer portal (Availity, NaviNet, payer-specific), fax (via Twilio integration), and phone (call-script generation with structured note-back). Channel is auto-selected by payer preference. Status is tracked in one queue regardless of channel.

03 What goes into the PA packet?

Diagnosis (ICD-10), level of care or service (CPT/HCPCS), treatment plan, medical necessity narrative pulled from the EHR, ASAM level if BH, attached results and imaging summaries, prior conservative-care notes when payer policy requires. All sourced from the chart with citation.

04 Does it handle peer-to-peer scheduling?

Yes. When a peer-to-peer is required, Adentris pulls the payer's peer-to-peer window, surfaces it in the queue with a countdown, and pre-stages the clinical summary for the calling clinician. Missed-PTP windows drop to near zero.

05 What if the EHR doesn't expose PA data through an API?

Most don't, in a useful form. Our AI agents can build a read-only API to the system, or the AI Web Agent reads the chart directly through the EHR UI: diagnosis section, treatment plan, medications, ASAM scoring sheets, scanned consult notes, signature blocks. No EHR-side integration required.

06 How is this priced?

Scoped to your organization: monthly prior authorization volume, payer mix, and which modules you turn on. Agreements are annual, with monthly payment available, and pricing is quoted after a short conversation rather than published as a list, and the rapid audit pilot shows results on your own authorizations before you commit. See plans by organization size →

See Prior Auth Autopilot on your PA queue.

Book a live walkthrough on your real payer mix, or ship us 60–90 days of PA submission logs and we'll benchmark your TAT against payer SLAs and quantify recoverable revenue from missed peer-to-peer windows.

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