The problem with prior auth
Prior authorization exists to make sure patients get appropriate care. Manual processes and fragmented systems have turned it into one of the biggest sources of care delays, frustration, and cost in healthcare.
Most prior authorization software focuses on the request. The cost is in what comes after: checking status, finding out why a request was denied, and confirming where the appeal goes and by when.
That answer lives with a payer representative, so the work happens on the phone, one call and one hold queue at a time. Patients left waiting call your contact center, or go elsewhere.
of staff time per manual prior auth, handled by phone, fax or email.
With Nora
0 min on hold. Nora makes the follow-up calls.
of prior auth work every week for physician and staff time, across 40 requests.
With Nora
Every denial comes back with the reason and the appeal deadline.
of physicians say it can lead patients to abandon treatment. 26% report a serious adverse event.
With Nora
Every patient gets a text the moment there’s an answer.
Sources: AMA 2025 Prior Authorization Physician Survey; CAQH Index.
How it works
Four acts, one request. She takes a prior authorization from stuck to decided, and puts every answer back where your team already works.
Every stuck request, spotted before anyone asks. Nora reads the pending prior auth work queue in the EHR, knows each plan’s decision clock, and calls urgent requests first, then the ones furthest past the clock, by your rules.
Nora works the phone menus, waits out the hold and says she is an automated assistant. Status, denial reason, appeal deadline and route, the rep and the reference are each read back before she records them.
Every denial sorted, the appeal drafted where the physician works. The decision, reason and reference go into the Auth/Cert record. PA Resolve matches the reason to its standard code, picks the next step and sets the deadline. The appeal arrives with the chart evidence, ready for a physician to sign.
Chased to a decision, with patients and staff told first. Nora confirms the payer has the appeal, with its case number and expected decision date, and checks until there is a decision. She records the approval and auth number, texts the patient and reminds staff before any deadline.
Write back
The answer lands where your team already works.
Illustrative record.
Prior authorization demo
A recorded call from Nora to a payer’s provider services line. Patient and case details are illustrative.
Her rules
Nora does what a person would do,
if a person were free.
On every call, every time. Today Nora covers Medicare Advantage, commercial, Medicaid managed care and ACA marketplace plans for advanced imaging: MRI, CT, PET, nuclear medicine, MR angiography and cardiac imaging.
Discloses she is automated
Every representative hears that Nora is an automated assistant calling on behalf of your health system, before anything else.
Reads back before recording
Every answer is read back to the representative and confirmed before it is written to the record.
Never promises an outcome
Nora records what the payer says. She does not predict a decision or make commitments the payer hasn’t made.
Never faxes or logs into portals
She works the payer phone line. When an electronic route already has the answer, the request leaves the queue and she never dials.
You set the rules
Call order follows your EHR work queue priority, with tie-breakers you control and payer decision clocks by plan type.
Payer lines, mapped
Mapped lines for prior auth status, appeal receipts and claim status across payers and benefit managers. New lines are mapped from recorded calls during onboarding.
FAQ
Questions about Nora
What prior auth, revenue cycle and IT teams ask before they start with one queue.
What does Nora do?
Does Nora submit prior authorization requests?
How does Nora check prior authorization status?
Does Nora tell payers she is an AI?
How does Nora make sure what she records is accurate?
Can Nora help with denials and appeals?
Does Nora make prior authorization decisions?
Does Nora integrate with your EHR?
Which plans and services does Nora cover?
How does Nora decide which requests to call about first?
How does Nora fit with CMS-0057-F and FHIR APIs?
Is Nora HIPAA compliant?
Will Nora replace our prior auth staff?
How do we get started?
Most teams start with payer calls and write back. Add denials and appeals, then patient follow-through, when you see it work.
Capabilities as designed.
CUSTOMERS
