READY-TO-DEPLOY AI AGENTS
A production-ready AI agent built for medical necessity
Magical’s Medical Necessity AI Agent evaluates clinical criteria, determines required documentation, and ensures submissions meet payer requirements. Runs continuously across your EHR, payer rules, and authorization workflows.
Medical necessity is complex, inconsistent, and drives denials
50%
Efficiency gains possible with automated medical necessity review
90%
Of admission reviews can be automated with the right criteria
$12+
Per authorization saved by automating medical necessity workflows
Automate medical necessity evaluation and documentation
This agent is pre-trained to run the entire authorization workflow. Deploy once on your systems, and it continuously processes incoming requests.
1. Ingest Clinical Data
Agent retrieves patient records, clinical notes, and encounter data from the EHR.
Agent evaluates cases against payer-specific medical necessity guidelines.
Agent identifies required documentation based on procedure, diagnosis, and payer rules.
Agent detects missing or insufficient clinical evidence that could impact approval.
Agent compiles and structures documentation required for authorization or billing.
Agent ensures all criteria are met before prior authorization or claim submission.
Agent updates workflows as payer rules or patient conditions change.
The Patient Access Suite
Clean claims start with cleaner patient access. Deploy a team of specialized AI agents to automate everything from referral intake to eligibility and prior authorization.
Deploy your AI agent in 3-4 weeks
1. Scope
Capture medical necessity workflows and payer criteria.
2. Build
Configure agent across clinical and authorization systems.
3. Train
Supervised runs refine evaluation logic and documentation handling.
4. Deploy
Agent continuously evaluates cases and ensures submission readiness.
Works across your existing healthcare systems
