Question 1

Our queue and plan mix are ours. What gets built versus what's already standard?

Accepted Answer

The per-case unit (sign in, submit, attach, capture the confirmation number) is the standard part; the high-volume harness around it is built per plan mix. Your worklist format defines the intake (member, provider, service details per case), your plan portals define which agents run, and the confirmation number and status are recorded against each case in your queue's shape. Failure isolation and escalation routing follow your review process. Staff stop clicking portals and start working only the exceptions; scoping against your volumes sets the rest.

Question 2

What access does a multi-plan PA queue require?

Accepted Answer

One credentialed portal account per health plan, each held in an agent profile. The agent signs in to that case's plan portal, so credentials stay scoped per portal and can be rotated or revoked plan by plan. Cases arrive from your worklist with member, provider, and service details; confirmation numbers and statuses are written back against each case. No plan APIs are needed: this workflow exists for the portals that don't offer one. Attachments come from each case's inputs. Security posture, including PHI handling, is on the security page.

Question 3

What happens when one case in the batch goes wrong?

Accepted Answer

It stops that case, and only that case. A missing field fails the case by name before submission; an eligibility mismatch or a clinical question the inputs don't answer escalates that single case to a person with the portal's dispute attached. The agent never fills a clinical gap itself. The failed case is reported and isolated while the rest of the queue keeps moving, which is the design point: at volume, the dangerous failure is the one that silently takes the batch with it. Portal or login changes surface the same way, as isolated, reported exceptions.

Question 4

At hundreds of cases, how do we verify nothing was skipped or mixed up?

Accepted Answer

Because there is no batch: only individual authorizations, each run as its own agent execution with its own audit trail. Every case records a confirmation number and status against its worklist row, so a skipped row or mixed-up member is visible as a case without evidence, not a hunch. Completed runs are distinct from business exceptions: a portal dispute escalated to staff is a correctly handled case, not a miss. No copied fields, assumed answers, or skipped confirmations: the shortcuts volume pressure invents are structurally impossible per run.

Question 5

What actually limits throughput: credentials, portal concurrency, payer rules, or review capacity?

Accepted Answer

Not the workflow: concurrency is a configuration choice. Each case runs as its own agent execution, so the queue is worked in parallel up to whatever rate the portal and your review process support. In practice the binding constraints are per-plan: what a given portal tolerates, and how fast your staff can clear the exceptions that escalate: the eligibility mismatches and clinical questions that need a person. Throughput grows by running more agents against the same worklist, not by hiring more people to be careful faster.

Question 6

How does the queue prevent duplicate submissions and surface the cases blocking the batch?

Accepted Answer

One case, one run, one confirmation number: the agent takes the next case from your worklist, submits on that plan's portal, and records the confirmation number and status against that specific case before moving on, so a case with evidence attached is visibly done and never re-worked. A case that fails (a named missing field, a portal dispute, a clinical question) is reported and isolated immediately rather than left ambiguous, and it never stops the queue. The blocked cases are exactly the ones sitting in your exception list with their reasons attached.

High-Volume Prior Authorization Submission

See it run on your systems.

A queue of authorizations, cleared one auditable case at a time

There’s no such thing as a batch. There are 400 individual authorizations.

What runs today

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