healthcare
Build Pre-Authorization Support Voice AI Agent
Automate prior authorization status inquiries with an AI agent that verifies member identity, retrieves PA cases, and explains next steps. Start building in Mission Control with usage-based pricing.
introduction
What this voice AI agent does
The Pre-Authorization Support template creates an AI agent for inbound PA status calls. It verifies caller identity, retrieves PA cases via webhook, and explains current status and next steps.
Designed for health plans and payer call centers fielding high volumes of PA inquiries, this template deflects routine calls so clinical staff can focus on complex cases.
The template comes pre-configured with member verification, PA case retrieval, and compliance-aware conversation flows.
features
Core components of the Pre-Authorization Support agent
Member verification
Verifies caller identity using name, date of birth, and member ID via webhook.
PA case retrieval
Fetches prior authorization cases and presents status, dates, and next steps clearly.
Status explanation and compliance-aware
Explains approval, denial, pending, and in-review statuses in plain language. Only shares information with verified members or authorized callers.
how to
Build and deploy your agent in 5 easy steps
time
5 minutes
pre-requisites
A Telnyx account with a phone number.
Step 1 of 5
1. Select the template
Sign in to your Telnyx account. Navigate to AI Assistants, click Create New Agent, and select Pre-Authorization Support from the Healthcare category.
2. Connect your PA system
Replace placeholder webhook URLs with your prior authorization system API endpoints.
3. Set organization details
Update the organization name in dynamic variables.
4. Customize status explanations
Update instructions with your specific PA statuses and next-step guidance.
5. Test and go live
Run test calls with sample member data to verify verification and case retrieval.
Thank you for calling. I can help you check the status of a prior authorization. Can you tell me your full name and date of birth?
tips and insights
Pre-Authorization Support voice AI best practices
Map your PA statuses
Ensure your webhook returns clear status labels with plain-language explanations.
Ensure your webhook returns clear status labels with plain-language explanations.
Handle provider vs member callers
Configure different verification flows for different caller types.
Configure different verification flows for different caller types.
Set escalation paths
Add transfer destinations for clinical review and appeals.
Add transfer destinations for clinical review and appeals.
