AuthFlow AI - Medical Pre-Authorization Assistant
AuthFlow AI eliminates the #1 administrative burden in healthcare — insurance pre-authorizations. Built for medical billing teams and clinic administrators, it uses autonomous AI agents to draft, submit, monitor, and appeal insurance authorizations automatically. AI drafts pre-auth forms in seconds Autonomous follow-up agent tracks every open request One-click denial appeal letters with clinical justification Payer rules database for all major insurers Role-based access for Admins, Billers, and Providers Clinics recover thousands in denied claims monthly. Stop chasing insurers manually — let AuthFlow do it for you. Perfect for: independent practices, billing companies, and multi-provider clinic groups.
Team structure
Lead
lead
Backend Developer
Frontend Developer
Mission
Build a SaaS web app called “AuthFlow AI” — an AI-powered medical pre-authorization assistant for healthcare clinics. Core Features: 1. Dashboard (Home) • Summary cards: pending authorizations, approved today, denials requiring appeal, average turnaround time • Revenue recovered tracker ($ value of approved claims) • Recent activity feed 2. Authorization Submission • Form to input: patient info, provider NPI, procedure CPT codes, diagnosis ICD-10 codes, insurance payer • AI agent auto-drafts the pre-auth request based on payer-specific requirements • One-click submission with status tracking (Pending / Approved / Denied / Under Review) 3. Follow-Up Agent • Autonomous agent monitors open authorizations • Sends follow-up reminders at 48h and 5-day marks • Flags stalled requests and suggests escalation steps 4. Denial Appeal Generator • On denial, AI drafts a formal appeal letter using clinical justification language • User can review, edit, and export as PDF • Tracks appeal outcomes 5. Payer Rules Database • Searchable list of major insurers (UnitedHealth, Aetna, BCBS, Cigna, Humana) • Each payer shows: typical turnaround time, required documentation, common denial reasons 6. Settings & Team • Clinic profile (name, NPI, tax ID) • Add staff members with roles (Admin, Biller, Provider) • Subscription plan display (Starter $299/mo, Pro $599/mo, Enterprise custom) Tech & Design: • Use Convex for database and auth • Clean, professional medical UI — white and blue color scheme, sidebar navigation • Mobile responsive • Role-based access control (Admin vs Biller vs Provider views) AI Agents: • Submission Agent: drafts pre-auth forms using patient + procedure data • Monitor Agent: tracks status and triggers follow-ups automatically • Appeal Agent: generates denial appeal letters with clinical justification Seed the app with realistic demo data: 3 staff users, 12 sample authorizations in various states (pending, approved, denied), 2 sample appeal letters, and payer data for the 5 major insurers listed above.