Best Claims Management Products

Magical’s Prior Authorization Agent is an advanced agentic AI solution purpose-built to automate the full prior authorization workflow—reducing delays, manual effort, and denials that burden providers and revenue cycle teams. Designed to act like a digital employee, the solution intelligently extracts clinical documentation from EMRs, determines the appropriate payer-specific requirements, completes the necessary forms, and submits them through the correct channels, whether by API, portal, or fax. Unlike traditional automation tools that rely on static rules or templates, Magical’s agentic AI operates with reasoning and adaptability. It can navigate unstructured systems, manage edge cases, and respond to real-time payer feedback without requiring human oversight. Once submitted, the agent continuously monitors the status of each request, follows up as needed, and flags any denials or exceptions that may require staff intervention. The result is a dramatic improvement in operational efficiency and patient access to care. Organizations using Magical’s Prior Authorization Agent have seen faster turnaround times, reduced administrative burden, and improved clean submission rates. By automating repetitive and error-prone tasks, it frees staff to focus on higher-value work and enhances the patient experience. Magical’s Prior Authorization Agent is easy to deploy, EMR-agnostic, and scalable across service lines. It brings together powerful AI, healthcare-specific workflows, and continuous learning to deliver consistent results in even the most complex payer environments. Whether your goal is to reduce cost, speed up access, or improve accuracy, Magical delivers automation that thinks, acts, and delivers—like your best employee, 24/7.

Alpha II delivers revenue integrity by enabling proactive denial intervention throughout the revenue cycle. We empower precision through coding, compliance, claims editing, quality reporting, and revenue recovery analysis. Our clients and partners include professional and acute care providers, clearinghouses, billing services, payers, government entities, consultants, and other healthcare software development companies. Serving a broad variety of clients allows us to hone the functionality, design, value, and effectiveness of our solutions with provided experience and insight.

Athelas builds health care technology powered by deep learning.

Most of the payers you’ll find on Essentials offer real-time authorizations. Just start with the basic information, and we’ll pre-populate as many of the fields as we can, and in just a few minutes you’ll have an answer that’s straight from the payer. We’re also working with several leading payers to simplify the process even more, with a question-and-answer format rather than the on-screen forms. Our new dashboards let you quickly check the status of all the auths requested by your office. For selected payers, you can even provide unsolicited attachments that you know the payer will need for approval. Once the visit is over, it's time to start the paperwork that gets you paid: claims.