Prior authorizations, assembled, submitted, and tracked to approval
Saga automates prior authorization for medical practices and health systems. Its AI agents pull the documentation each payer requires from the chart, assemble the request, submit it through the payer’s portal, track it to a decision, and write the outcome back to the EHR, across medical, pharmacy, and DME benefits. Denials and other sensitive items go to staff for approval.
Built for → Orthopedics & ASCs · Radiology & imaging · Infusion
Prior auth is mostly gathering, re-keying, and waiting.
Staff find the right notes, match them to the payer’s criteria, re-key everything into a portal, then check back for days. Requests pile up in a queue, and when someone is out, the queue stops moving and patients wait for care.
How Saga handles a prior authorization
Detects the need
An inbound order or referral triggers a prior-authorization check against the patient’s plan and the requested service.
Assembles the request
Saga gathers the history, medications, diagnoses, and supporting documentation from the chart that the request requires.
Submits through the payer portal
Saga completes and submits the request in the payer’s portal, the same way an experienced prior-auth specialist would.
Tracks to a decision
Saga follows up on pending requests and records approvals, denials, and reference numbers in the EHR.
Escalates the exceptions
When a request is denied, Saga drafts the appeal and places it in the review inbox for staff approval before anything is sent.
What Saga covers
- Medical-benefit prior authorizations for procedures, imaging, and infusions
- Pharmacy-benefit prior authorizations
- DME prior authorizations
- Status tracking with decisions written back to the chart
- Denial appeals drafted for staff approval
- A live view of every pending request and what is blocking it
Fewer hours on paperwork. More capacity for patients.
Prior authorization questions
Can Saga submit prior authorizations automatically?
Yes. Saga assembles and submits prior authorization requests through payer portals. Each practice chooses which actions need staff sign-off, and denials and appeals always do.
Which prior authorizations does Saga handle?
Saga handles prior authorizations across medical, pharmacy, and DME benefits, including procedures, imaging, and infusions.
What happens when a prior authorization is denied?
Saga flags the denial, drafts an appeal from the chart documentation, and places it in a review inbox. Nothing is sent until a staff member approves it.
Does Saga work with my EHR?
Saga works inside Epic, Cerner, athenahealth, eClinicalWorks, MedENT, and other EHRs. It uses a computer-use agent that operates the EHR the way a staff member would, so no API integration or IT project is required.
What results do practices see?
In early multi-site deployments, practices saw 94% less manual back-office work and a 48% increase in labor capacity. Results depend on volume and workflow, so Saga models expected figures against each practice’s own volumes during onboarding.
Comparing options? See how Saga compares with fax OCR, RPA, and outsourced intake →
Clear your prior-auth backlog.
Live in under a month · writes back to your EHR · your data stays yours