How to Automate Prior Authorization Phone Calls with Payers

Prior authorizations are one of the most time-consuming and frustrating administrative burdens in healthcare. According to the American Medical Association, providers complete an average of 45 prior authorizations per physician each week, with many of these requiring lengthy phone calls to payers.

Manual phone-based prior authorization workflows lead to:

• Long hold times and call transfers
  
  
• Repeated follow-ups to check authorization status
  
  
• Delays in patient care and provider cash flow
  
  
• High administrative overhead for billing teams
  
  

Fortunately, recent advances in agentic AI and voice automation are transforming how providers handle payer calls. It’s now possible to automate large portions of prior authorization phone calls—freeing staff from repetitive work while accelerating approvals.

Here’s how to do it.

Why Phone-Based Prior Authorization Is Ripe for Automation

While electronic prior authorization portals and APIs exist, phone calls remain unavoidable for many payers. Some require additional clinical documentation to be verified over the phone; others still rely on legacy call center workflows.

This makes phone calls an ideal candidate for automation because:

• They are structured but repetitive (same steps and scripts each time)
  
  
• They consume high-value staff time
  
  
• They follow predictable rules and outcomes (check status, submit information, or escalate)
  
  

By deploying AI agents to handle these tasks, providers can reduce manual call volume, cut hold times, and eliminate redundant follow-ups.

Key Capabilities of Automated Prior Authorization Calls

Modern automation platforms use AI-powered voice agents and integrated workflow orchestration to streamline the prior authorization process. Effective systems include:

• AI Voice Agents
  Conversational AI systems that can call payer lines, navigate IVR menus, and interact with payer representatives to request or verify prior authorization information.
  
  
• Context-Aware Workflow Automation
  Agents automatically pull patient and case data from EHR or RCM systems, ensuring the correct information is provided to payers during each call.
  
  
• Real-Time Documentation
  Every call is logged, transcribed, and tied to the corresponding prior authorization record, reducing compliance risk and manual note-taking.
  
  
• Escalation Rules
  When a call requires human intervention (e.g., additional clinical documentation), the system hands off seamlessly to staff.
  
  
• Status Tracking and Follow-Ups
  Automated re-calling and status checks reduce the need for manual follow-up work by revenue cycle teams.
  
  

Steps to Automate Prior Authorization Phone Calls

Map Your Current Workflow

Start by documenting how your team currently handles prior authorization calls. Identify:

• Which payers require the most manual phone calls
  
  
• Average call duration and volume
  
  
• Common call outcomes (status checks, submissions, appeals)
  
  

This baseline helps you design an automation workflow that mirrors real-world operations.

Select the Right Automation Platform

Look for an automation partner with:

• HIPAA-compliant infrastructure
  
  
• Native voice AI capabilities
  
  
• Integration with your EHR, practice management, or RCM system
  
  
• Detailed audit logs and reporting for compliance
  
  

Configure AI Agent Workflows

Design call scripts and escalation pathways. For example:

• “Call Payer X → Navigate IVR → Provide authorization ID → Confirm status → Record response → Update patient record.”
  
  

Test with a Limited Payer Pool

Start small by automating a subset of payers or call types (e.g., status checks only). Validate accuracy, compliance, and staff satisfaction before scaling.

Expand and Optimize

Once your team is confident in automation performance, add more payers, automate more call types, and refine your escalation workflows for edge cases.

Best Practices for Success

• Maintain Human Oversight
  Even with automation, clinical and compliance staff should review call transcripts and flagged exceptions.
  
  
• Integrate with RCM Workflows
  Ensure automated call outcomes feed directly into claims and authorization tracking systems.
  
  
• Measure ROI Early and Often
  Track metrics like average call duration, successful status retrievals, and reduction in manual call volume to quantify the impact.
  
  
• Prioritize Compliance
  Confirm that your automation partner supports encryption, audit trails, and HIPAA-aligned handling of PHI.
  
  
• Train Staff to Work Alongside AI
  Position automation as a tool that eliminates repetitive calls—not as a replacement for critical human judgment.
  
  

How SuperDial Automates Prior Authorization Calls

At SuperDial, our agentic AI platform eliminates the manual pain of payer calls by:

• Automatically dialing payers, navigating phone menus, and retrieving prior authorization statuses
  
  
• Logging every interaction with payer call centers in structured, reviewable records
  
  
• Integrating with provider RCM systems to update prior authorization workflows in real-time
  
  
• Escalating complex cases to staff instantly, without breaking compliance
  
  

By automating routine phone calls, providers see faster prior authorization turnaround, fewer administrative hours, and improved revenue cycle performance.

Automating Phone Calls Is the Next Step in Prior Authorization

Prior authorization will remain a fact of life in healthcare for the foreseeable future—but it doesn’t have to be a manual burden. By automating payer phone calls, providers can reduce friction, accelerate approvals, and focus staff resources where they matter most: patient care.

Ready to automate your prior authorization phone calls?
Talk to SuperDial about how our agentic AI platform can streamline payer interactions from start to finish.

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