Prior Authorization Agent
Assembles payer-ready packets from documentation that already exists, and tracks each request to a decision.
You sign before anything is submitted.
Meet this agentMedera for prior authorization
Approvals,
without the phone tree.
Prior auth is where care goes to wait. Medera assembles payer-ready packets from documentation that already exists, and tracks every request to a decision.
Clean claim
Today's claim
90837
Psychotherapy · 60 min
F41.1
Generalized anxiety
96127
Brief assessment
Suggested with evidence, right the first time
Built for
Payer packetsMedical necessityAppealsTracking
Documentation
Packets that assemble themselves
Medical necessity drawn from real session documentation, formatted to each payer's requirements, ready to sign, not to start.
Explore DocumentationClean claim
Today's claim
90837
Psychotherapy · 60 min
F41.1
Generalized anxiety
96127
Brief assessment
Suggested with evidence, right the first time
Measurement
Evidence attached
Score trajectories and treatment response included automatically, the strongest case for continued care, made by the data.
Explore MeasurementImproving
PHQ-9, six weeks
Check-ins sent, scored and charted for you
Co-therapy
Tracked to the decision
Every request followed until it resolves, with renewals queued before authorizations lapse, no calendar reminders required.
Explore Co-therapy6+ hrs
back in your week, every week
Evenings are yours again
Your new colleagues
The agents on your team.
For prior authorization, these are the agents that carry the most. Each hands you a draft, a flag or a packet, and waits for your review.
Eligibility Agent
Checks coverage and benefits ahead of the visit, so questions about cost come up early, not at checkout.
You see the result before anything reaches the client.
Meet this agent
Scribe Agent
Drafts the note in your structure and your voice, waiting for you by the time the session ends.
Nothing is filed without your signature.
Meet this agent
Billing & Claims Agent
Checks each claim against the documentation and hands it to your billing stack.
Codes reach a claim only after your approval.
Meet this agentWhat changes
More care. Less admin. Every week.
2:1
hours of desk work for every hour of care today. That is the ratio Medera exists to change.
Same day
the note is drafted before the session ends, and signed before you leave.
Every task
around the work, quietly carried.
Enterprise-grade
Enterprise-grade for
every size of practice.
Solo practice or health system, the guardrails don't scale down. The same architecture protects every session, on every plan.
Consent-first, always
Documented consent opens every session, no consent, no capture, no exception.
Encrypted, BAA-backed
Healthcare-grade encryption in transit and at rest, with business associate agreements signed.
The approval gate
Every agent output, note, code, letter, escalation, waits for a licensed clinician's sign-off.
Audit trail on everything
Every access, action and export logged to a person, reviewable and exportable.
SSO, roles & supervision
Enterprise identity, role-based access and supervisor review flows for teams and programs.
Never trains on your sessions
Client data never trains foundation models, contractually and architecturally.
100%
of agent output held behind clinician approval
0
sessions used to train foundation models
Every
action logged and auditable
In depth
Why authorisation is a documentation problem
Almost every denial is an evidence problem rather than a clinical one. The care was necessary; the packet did not demonstrate it in the form that plan required.
Per-plan requirements
Payer criteria are learned per plan during implementation rather than assumed. What one plan needs to see, and in what order, is not what the next one needs.
Assembled from the record you have
Diagnosis, severity, prior treatment, response and clinical rationale are already in your notes. The packet is built from them rather than by asking you to restate them in a portal.
Denials and appeals
A denial reason maps back to what was missing, and the appeal is assembled with it. Resubmission is where practices lose the most time and where the work is most mechanical.
You still decide
Medera never asserts medical necessity on your behalf. It assembles the evidence for a determination you make and sign.
The question we get asked
“Every payer wants a different packet. Does it actually know ours?”
Payer requirements are learned per plan during implementation, not assumed. The packet is assembled from the clinical record you already have, in the form that plan asks for, and it waits for your approval before it goes. The work that disappears is the assembly and the resubmission, not the clinical judgment about what is medically necessary.
FAQ
Questions, answered.
Will Medera get in the way of the session?
The opposite. Medera has no camera presence and no voice in the room, it listens with consent, stays out of sight, and frees you from the keyboard so you can stay eye-to-eye with your client.
Who signs off on the work?
You do, always. Every note, letter, code and escalation is drafted for your review and filed only with your signature. Medera never acts on its own.
Is Medera HIPAA compliant?
Yes. Encryption in transit and at rest, audit trails on every action, BAAs for covered entities, and access controls designed for behavioral health's higher bar of confidentiality.
