Prior Authorization

StreamAuth™

Operational PA reforms are live January 2026. Full FHIR PA API mandate takes effect January 2027. RSAI clients are compliant from day one for both.

Core Capabilities

  • Automatic PA requirement detection based on payer, plan type, and procedure
  • AI reads EHR records and assembles payer-specific clinical justification package
  • Electronic PA submission — fully compliant with CMS-0057-F
  • Real-time status tracking via payer portal — no manual calls required for portal-connected payers
  • Automated follow-up when information requested or SLA exceeded
  • AI-generated appeal briefs mapping denial reason against clinical record
  • Approval rate analytics by payer, procedure, and provider
  • When a payer requires a phone call, StreamCall automatically handles IVR navigation — no manual dialing or hold time
CMS-0057-F — Operational Jan 2026 · Full FHIR PA API Jan 2027

StreamAuth is architected to both phases from day one. Most competing RCM platforms have not yet built for either deadline.

Prior authorization
Prior auth in 4 minutes. Not 4 days.
streamauth · processing
Approved This Week
39 / 47
83% approval rate
Avg. Submission Time
4 min
vs. 12 min manual
How it works

Prior auth, end to end — without the manual paperwork.

AI assembles clinical docs, submits via FHIR ePA where supported, and tracks every approval state in real time.

streamauth flow PA Needed Trigger detected Docs Assembled Notes + criteria ePA Submitted FHIR / portal Approved Care can proceed streamauth flow (mobile) PA Needed Trigger detected Docs Assembled Notes + criteria ePA Submitted FHIR / portal Approved Care can proceed

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See how RSAI moves revenue from intake to final payment.

FAQ

StreamAuth — frequently asked questions

It uses AI to assemble the required clinical documentation, submit prior authorization requests to payers, and track approvals automatically — replacing a manual, time-consuming process.
StreamAuth gathers the clinical documentation, completes payer-specific requirements, submits the request, and monitors status through approval.
Yes. StreamAuth is designed to support the CMS-0057-F prior authorization requirements.
All standard prior authorization categories — imaging (MRI/CT/PET), surgical procedures, infusions, behavioral health, physical therapy, durable medical equipment, and specialty pharmacy. Payer-specific medical-necessity criteria are built in.
Commercial payers: 14 calendar days minimum. Medicare Advantage non-urgent: 7 days. Many surgical procedures require 30 days. StreamAuth flags submission deadlines automatically based on the payer's published SLA.
StreamAuth automatically drafts a peer-to-peer request with supporting clinical evidence, or escalates to a formal appeal — whichever the payer's process requires. Average overturn rate on denied PAs is 64%.
Yes. StreamAuth is built around the CMS Interoperability and Prior Authorization final rule — supporting electronic PA submission, status tracking, and turnaround SLAs ahead of the 2027 deadline.