An autonomous AI agent that handles prior authorizations, claim denials, and appeals for independent medical practices. No enterprise contracts. No six-figure invoices.
Claim denials have risen every year for over a decade. Insurance companies use AI to deny faster. Practices still appeal by hand.
The average independent practice employs 1-2 people whose entire job is fighting insurance paperwork, prior auth, and denials.
Current AI tools (Cohere, Waystar, Availity) target large health systems with six-figure contracts. Small clinics get nothing.
AuthGrove monitors, submits, tracks, follows up, and appeals. It learns your payers, knows your workflows, and works autonomously. You check in when you want to, not because you have to.
Detects when auth is needed, pulls clinical data, submits to payers, and tracks status. Follows up automatically when decisions stall.
Catches denials the moment they hit. Analyzes the reason code, identifies appeal-worthy cases, and drafts evidence-backed appeals.
Verifies patient insurance eligibility and benefits before appointments. Flags coverage gaps so you never get surprised at billing time.
Monitors credentialing status with every payer panel. Alerts you before expirations. Keeps your revenue stream uninterrupted.
AuthGrove exists so independent practices can compete with hospital systems on admin efficiency without spending hospital system budgets. The CMS 2026 electronic prior auth mandate is here. The AI tools are ready. The only question is who's going to use them first.