AI Agents for Eligibility and Prior Authorization: How Adonis Simplifies Coverage Discovery and Speeds Up Auths

In today's healthcare revenue cycle, eligibility verification and prior authorization remain two of the most time-consuming and error-prone processes. Delays in benefits discovery and authorization requests can lead to denied claims, revenue leakage, and frustrating patient experiences. But thanks to advances in artificial intelligence, there’s a better way.

AI Agents Are Redefining Benefits Verification and Authorization

Having AI agents for benefits and authorizations is like having a dedicated assistant that can instantly check a patient’s coverage, identify prior authorization requirements, and kick off the approval process, without manual intervention.

Adonis AI Agents are purpose-built to remove friction from the eligibility and authorization process. These intelligent, task-specific agents don’t just augment your RCM team, they operate autonomously to complete high-volume, rules-driven tasks with speed and accuracy.

Here’s how it works:

1. Instant Coverage Discovery with AI for Checking Patient Eligibility

Instead of relying on staff to manually search through payer portals or place phone calls, the AI assistant for benefits verification proactively checks patient eligibility in real-time. Adonis Agents retrieve detailed plan information and surface insights around coverage gaps, limitations, and required documentation, all before the patient even walks in the door.

This reduces downstream denials, improves scheduling accuracy, and ensures patients are informed of their financial responsibility upfront.

2. Automated, Intelligent Prior Authorization Workflows

Traditional prior authorization is slow, repetitive, and costly. But with AI for prior authorization, Adonis transforms this workflow into a high-speed, hands-off process.

When Adonis Intelligence flags a prior authorization related denial, agents are deployed to gather the necessary information to retrieve the authorization and get the claim paid. This not only accelerates turnaround time but also frees staff to focus on higher-value tasks.

3. Scalable, End-to-End Management of Insurance Authorizations

Whether you’re processing 100 or 10,000 requests per month, AI to manage insurance authorizations ensures nothing slips through the cracks. Adonis AI Agents continuously track auth statuses, flag at-risk requests, and provide real-time updates so your team stays ahead of potential delays or denials.

By automating this complex and variable-heavy process, Adonis helps providers unlock revenue, improve throughput, and reduce the risk of uncompensated care.

The Future of Revenue Cycle is AI-Orchestrated

Eligibility and authorization are just the beginning. With the Adonis AI agents, RCM teams can build scalable, intelligent workflows that adapt to payer policies, optimize staff time, and ultimately improve financial performance.

Want to see Adonis AI Agents in action?
Get a demo and discover how our platform can help you simplify coverage discovery and speed up prior auths.