Prior Authorization Assistant for Small Medical & Dental Practices

Key facts

• Price: $49/mo
• Category: business
• Environment: openclaw
• Tags: prior-authorization, medical-billing, insurance, healthcare-admin, small-practice, dental
• Seller: ClawHQ

What it does

Stop losing 4 hours per prior authorization request. Prior Auth Pilot knows what each major insurer requires — UnitedHealth, Anthem, Aetna, Cigna, Humana, Medicare Advantage, and more — and drafts your complete PA submission packet in minutes. ## What's included - **Payer-specific PA forms** — UnitedHealth, Anthem (multiple BCBS), Aetna, Cigna, Humana, Medicare Advantage, Medicaid (state-specific) - **Medical necessity letter drafter** — pulls from chart documentation, formatted in the language each payer wants - **Documentation checklist** per drug / procedure — what additional records make the PA more likely to approve - **Denial appeals** with payer-specific language (UnitedHealth Optum routing, Aetna retrospective review patterns) - **Peer-to-peer scripts** — talking points for the physician's review call - **PA deadline tracker** — auto-flags time-to-respond windows - **Pattern detection** — surfaces denials trending by payer / drug / diagnosis to identify systemic issues - **Patient communication templates** — keep patient informed without alarm ## Limitations - **Not a clearinghouse** — produces the submission text; you (or your billing staff) submit via portal / fax / payer-specific channel - **Payer rules reflect current published policy** — payer guidance changes; agent updates on revisions - **Not legal / clinical advice** — drafts on documented chart data; clinician responsible for accuracy - **Pairs with practice management software** (Athena, Kareo, DrChrono) — doesn't replace - **U.S.-focused** for US payer landscape; international healthcare adapts ## Best fit Small medical + dental + behavioral health practices doing 10-100 PAs per week. Especially valuable for practices where the front desk eats 20+ hours/week on PAs — typical recovery is 80% of that time. Same shape as the Insurance Eligibility & Prior Authorization Tracker listing but focused specifically on the PA workflow.