Champ AI
Healthcare automation

Prior authorization automation

Move prior authorizations forward before care gets delayed.

Champ checks payer requirements, assembles the clinical packet, submits through the required channel, and follows every authorization until it is approved or needs a clinician's review.

HIPAA-ready Managed by Champ Self-healing

Prior authorization queue

Every requirement, submission, and follow-up

Live
Work itemStatus
01

Authorization requirement

Plan and procedure rules confirmed

Verified
02

Clinical packet

Order, notes, and supporting records assembled

Complete
03

Payer submission

Portal submission and reference captured

Submitted
04

Clinical exception

Medical-necessity response needs review

Escalated

EXECUTION

Continuous

EVIDENCE

Every step

OWNER

Champ

One queue

across every payer

Complete

before submission

Continuous

status follow-up

The operational bottleneck

Every payer turns one order into a different process.

Authorization rules, forms, clinical criteria, submission channels, and follow-up timelines vary by payer and service. Staff have to reconstruct the case across the EHR, payer portals, fax, and phone while the patient waits.

Bring us your workflow
01

Requirements change by plan, procedure, medication, and place of service

02

Clinical evidence is scattered across orders, notes, imaging, and lab results

03

Submissions move through payer portals, ePA tools, fax, and phone

04

Pending cases require repeated status checks and time-sensitive responses

The production workflow

One continuous operation, not another disconnected tool.

Champ coordinates browser, document, API, voice, and human steps around the outcome your team is responsible for.

  1. 01
    Confirm the authorization path

    Verify eligibility, plan details, procedure or medication codes, servicing provider, and payer-specific authorization requirements before work begins.

  2. 02
    Build a complete clinical packet

    Collect the order, diagnosis, treatment history, chart notes, imaging, labs, and other required evidence, then identify anything missing.

  3. 03
    Submit through the required channel

    Complete payer or ePA forms, upload supporting records, submit through the portal or fax workflow, and capture the confirmation and reference number.

  4. 04
    Follow through to a decision

    Check status on schedule, respond to administrative requests, write results back to the source system, and route clinical review, peer-to-peer, or appeal decisions to authorized staff.

Why it stays reliable

Built around the work, not a brittle integration map.

Your systems can stay exactly where they are. Champ operates across them, records what happened, and improves the workflow as the process changes.

Payer-specific requirements
Apply the correct forms, clinical-document checklist, submission channel, and follow-up cadence for each plan and requested service.
Portal, document, fax, and voice execution
Coordinate the full authorization workflow even when the work crosses systems and a useful end-to-end API does not exist.
Clinical judgment stays with clinicians
Automate administrative work while routing medical-necessity questions, attestations, peer-to-peer reviews, and appeal decisions with the full case context attached.

Works with your stack

If your team can access it, Champ can work in it.

Use APIs where they are dependable and managed browser agents everywhere else. No rip-and-replace required.

AvailityCoverMyMedsPayer authorization portalsElectronic prior authorization platformsEHR systemsPractice-management systemsDigital fax platformsPhone and IVRDocument repositories

Change the operating model

Give your team exceptions, not another queue to babysit.

Manual operation
More volume becomes more repetitive work.
  • Staff look up authorization rules one case at a time
  • Clinical records are gathered and attached by hand
  • Status checks compete with new requests throughout the day
  • Denials arrive without a complete, review-ready case history
Recommended
Operated by Champ
More volume becomes more completed outcomes.
  • Each request starts on the correct payer-specific path
  • Required evidence is assembled and validated before submission
  • Follow-up continues automatically until there is a decision
  • Clinicians receive only the exceptions that need their judgment

More healthcare workflows

One platform across the back office.

Insurance eligibility & benefits verification
Champ verifies commercial, Medicare, Medicaid, and Medi-Cal coverage across every required source, then completes the plan-specific work that a standard eligibility response leaves behind, including benefits, authorization requirements, and ECM qualification.
Provider credentialing & enrollment
Champ keeps provider profiles complete, submits enrollments across payer portals, follows every application, and sends only true exceptions to your credentialing team.
Referral intake & submission automation
Champ reads incoming referrals, validates the packet, creates the patient record, submits through the required portal or fax channel, and follows every case until it is accepted or needs review.

Prior authorization automation FAQ

Questions healthcare operators ask first.

You have more questions?

Send us an email

Do the work of fifty
without hiring one more.

Eligibility
Verification
Claims
Payroll
Carrier check-in
Patient intake
Benefits
Credentialing
Credentialing