15K+ Auths Processed Monthly 94% First-Pass Approval 3min Avg. Submission Time 24/7 Always-On Processing
Meet Your AI Workforce
◆ Prior Auth Agent — Analyzes clinical documentation, maps to payer-specific criteria, compiles supporting evidence, and submits authorization requests automatically. Handles commercial, Medicare, and Medicaid payers across all service lines.
◆ Appeals Agent — When authorizations are denied, the Appeals Agent analyzes denial reasons, gathers additional clinical evidence, drafts peer-to-peer preparation materials, and submits structured appeals with a 78% overturn rate.
◆ Referral Management Agent — Automates specialist referral workflows including insurance verification, clinical summary preparation, and appointment coordination. Ensures patients reach the right provider faster.
◆ Utilization Review Agent — Continuous monitoring of inpatient stays, concurrent review automation, and discharge planning support. Ensures clinical necessity documentation meets payer requirements throughout the episode of care.
How AI Agents Work
1. Intake & Analysis — The agent receives a task (e.g., prior auth request), analyzes the clinical context using ZynixLLM, and identifies the relevant payer criteria, CPT/ICD codes, and supporting documentation needed.
2. Evidence Compilation — Automatically pulls clinical notes, lab results, imaging reports, and medication history from your EHR via certified integrations. Synthesizes a compliant submission package.
3. Execution & Submission — Submits to payer portals, tracks status, responds to information requests, and escalates to human staff only when clinical judgment is required. Orchestrated by Zynix OS.
4. Learning & Improvement — Every outcome feeds back into the agent, improving payer-specific strategies, identifying documentation patterns that drive approvals, and continuously optimizing first-pass rates.
Explore the Zynix Ecosystem
→ Zynix Platform — Unified AI operating system | → ZynScribe — Ambient documentation | → ZynixLLM — Healthcare language model
→ Health Systems | → Health Plans | → ACOs & MSOs | → Case Studies
Put AI Agents to Work Today
See how autonomous AI agents can eliminate your biggest administrative bottlenecks.
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HIPAA Compliant · SOC 2 Type II · HITRUST CSF · BAA Available
