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 payor-ready packets. Submits via the channel each payor prefers. Tracks every peer-to-peer window.
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.
How it works
Generate, submit, track, escalate. One queue.
Read the chart
Agent pulls diagnosis, level of care, treatment plan, ASAM level for BH, conservative-care notes, and supporting results from the EHR.
Generate the packet
Medical necessity narrative tailored to the payor's medical policy. CPT/HCPCS, ICD-10, attachments. Reviewer-approval queue before submission.
Submit any channel
Payor portal (Availity, NaviNet), fax, or phone. Channel selected by payor preference. Status tracked in one queue regardless.
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.
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
COO, Resilient Recovery Treatment
Side by side
Adentris vs the alternatives.
Capability
Adentris
Manual PA
Other PA tools
Packet generation
60 seconds, chart-cited
20–30 min per PA
Template-based, payor-dependent
Submission channels
Portal + fax + phone, one queue
Portal only, or fax-by-hand
Portal-only, payor-by-payor
Peer-to-peer tracking
Real-time countdown, payor-specific windows
Spreadsheet or memory
Limited or none
EHR integration
AI Web Agent, no API, 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
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 payor response with the original electronic decision so your team has the audit trail when CMS asks.
02 Which channels does it submit through?
Payor portal (Availity, NaviNet, payor-specific), fax (via Twilio integration), and phone (call-script generation with structured note-back). Channel is auto-selected by payor 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 payor 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 payor'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. 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?
Free tier with 5 PA generations per month per user. Starter at $100/month for 25 per user. Enterprise is annual, tied to monthly PA volume, includes EHR integration via AI Web Agent, custom payor rules, dedicated CSM, BAA, and SLA.
See Prior Auth Autopilot on your PA queue.
Book a live walkthrough on your real payor mix, or ship us 60–90 days of PA submission logs and we'll benchmark your TAT against payor SLAs and quantify recoverable revenue from missed peer-to-peer windows.