LOOMAL
AI Prior Authorization

Prior auths submitted
before the patient asks why.

Prior authorization is the most-hated workflow in American healthcare. Every payer has its own portal, its own form, its own wait time. A Loomal agent assembles the request, logs in with stored credentials, submits, and tracks the response — turning weeks of phone tag into a quiet background workflow.

vault_getvault_totpmail_send

API Primitives used

vault_get

Pull payer credentials

Login credentials for every payer portal live encrypted in the vault, scoped to the clinic identity.

vault_totp

Handle 2FA on portals

Many payer portals require 2FA. Agent generates TOTP codes from encrypted seeds without exposing them.

mail_send

Notify the team

Submission confirmations and approval results get emailed to the care team from the clinic identity.

Prior auth is healthcare's worst workflow.

Every clinic has staff dedicated to prior auth. They log into a dozen payer portals, type the same patient information, fax forms, wait, call, fax again. The work has zero clinical value and consumes hours per case — and patients wait through it for treatment they need now.

An agent fixes the structural problem. With encrypted credentials, automated portal navigation, and clean audit, the request submission runs in minutes instead of hours. Care teams stay focused on patients; the agent handles the bureaucracy.

How to build it.

01vault_get

Pull credentials

Agent reads the right payer's portal credentials from the vault for the request being submitted.

02vault_totp

Authenticate and submit

Agent handles 2FA with TOTP, navigates the portal, and submits the prior auth with the assembled clinical data.

03mail_send

Track and notify

Agent watches for approval responses and emails the care team from the clinic identity when results arrive.

Example prompt

For every new MRI order, submit a prior auth to the patient's insurance through their portal. Pull credentials from the vault, handle 2FA, and email the care team when the auth is approved.

What clinics build.

Imaging auths

Agent handles imaging prior auths across every payer the clinic accepts.

Specialty drug approvals

Specialty pharmacy auths run through the agent with consistent data and faster turnaround.

Procedure approvals

Surgery and procedure auths get submitted the moment the order is placed.

Denial appeals

When auths are denied, agent assembles the appeal package with supporting documentation.

Status tracking

Agent polls payer portals for status updates and notifies the team when responses arrive.

Why prior auth needs a vault-backed identity.

Payer portals are the worst credential environment in software. Every portal has a different login flow, different 2FA, different session timeout. Sharing credentials across staff is a HIPAA risk; managing them in a password manager is a logistics nightmare. The right answer is to take the credentials out of human hands entirely.

Loomal gives the prior auth function its own identity that holds every payer credential encrypted, handles 2FA from sealed seeds, and logs every submission. Care teams stop drowning in portal work; compliance gets the audit trail HIPAA expects.

Payer credentials encrypted

Every portal login lives in AES-256-GCM vault entries scoped to the prior auth identity.

Per-submission audit

Every login, submission, and result is logged with timestamp and delegation chain.

HIPAA-grade attribution

Each agent action ties back to the clinician who authorized the workflow.

Related use cases

End the prior auth phone tag.

Credentials, submission, and tracking — fully autonomous.