SPRY Launches AI Solution Automating 80% Prior Auth for Rehab Clinics

New answer delivers real-time, limitless eligibility verification and helps practices put together for CMS’s 2026 mandate.

SPRY Therapeutics Inc. at this time introduced the launch of the SPRY Prior Authorization & Eligibility Solution, the primary AI-powered answer purpose-built for rehab remedy clinics. The answer automates as much as 80% of prior authorization workflows whereas guaranteeing all authorizations are accomplished via a mixture of AI automation and skilled overview. It reduces associated denials by as much as 75% and gives real-time, limitless eligibility verification whereas streamlining processes throughout main payers, together with Carelon/BCBS, UnitedHealthcare, and Humana.

SPRY’s answer arrives at a crucial juncture as rehab remedy clinics put together for CMS’s 2026 digital prior authorization mandate. The platform’s FHIR-compatible APIs assist integration with evolving digital authorization necessities. AI brokers handle the end-to-end authorization workflow, from studying medical documentation to submitting requests and securing approvals, whereas processing authorizations as much as every week earlier than scheduled appointments. This advance timeline offers clinics the chance to resolve discrepancies earlier than sufferers arrive. Real-time checks assist walk-ins and assist cut back last-minute cancellations.

“Prior authorization is mission-critical for affected person care—when it fails, sufferers can’t obtain remedy and practices lose income,” stated Brijraj Bhuptani, cofounder and CEO of SPRY. “We have already got remedy practices dwell on our platform the place our AI reads therapist documentation, completes payer medical questionnaires, and secures authorizations as much as every week earlier than sufferers arrive. These clinics haven’t had authorization-related appointment cancellations in months. The future isn’t about monitoring authorizations, it’s about AI that executes the work so therapists can keep targeted on what they do greatest: treating sufferers.”

AI Agents Execute Complete Authorization Workflow

SPRY’s customized AI brokers handle the end-to-end authorization workflow, from dedication via approval, lowering guide intervention for most instances whereas proactively figuring out expiring authorizations and initiating renewals earlier than they have an effect on affected person care. The platform incorporates built-in verification protocols with automated audit trails to make sure accuracy previous to submission. The automation adapts to deal with advanced authorization situations and payer web site modifications mechanically. To maximize accuracy, SPRY makes use of a human-in-the-loop high quality assurance layer, guaranteeing all instances are validated earlier than submission, so clinics profit from each automation velocity and skilled oversight.

The system runs eligibility checks mechanically at scheduling, with built-in verification that flags suspicious values for fast overview. SPRY’s therapy-specific guidelines engine understands necessities equivalent to go to caps and modality limitations, with nightly re-verification carried out for plans topic to mid-month modifications.

The platform works seamlessly inside SPRY’s EMR or as a standalone service linked to third-party EMRs, enabling clinics to handle authorizations and eligibility from a single dashboard with out portal-hopping.

Early Adopters Report Significant Operational Improvements

Renew Physiotherapy achieved denial charges of simply 0.57% over two months of dwell operation whereas automating 75% of its authorization workflow.

“We used to have workers spending hours a day calling insurance coverage firms, coping with the frustration of being on maintain and getting totally different solutions from totally different representatives,” stated Samantha Strickland, bodily therapist and co-owner at Ultimate Therapy. “With SPRY, that workload has been reduce dramatically, and we get approvals a lot quicker. Beyond the effectivity, it looks like such a reduction to have SPRY on our facet as a smaller follow. I now really feel like I’ve the experience of a much bigger participant serving to us go head-to-head with insurance coverage firms to get reimbursed what we’re purported to.”

Platform efficiency metrics validate these outcomes:

• 99% of eligibility recordsdata processed in beneath one hour
• 95%+ eligibility match fee throughout main payers
• 80% discount in administrative burden associated to authorization duties
• 95% discount in authorization submission time (1.5 minutes with AI vs. 20+ minutes manually)

The SPRY Prior Authorization & Eligibility Solution is now accessible nationwide.

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