Prior auth turnaround averages 7-10 days with a 30% denial rate. Patient no-show rates run 15-25%. Insurance verification lag costs $80 per claim re-work. Charting eats 2 hours per provider per day. Patient recall lapses leave 25% of your panel past due. LouDNAi deploys nine BAA-eligible agents — purpose-built for clinical practices — that close the gap in 21 days.
Same nine BAA-eligible archetypes parameterized per sub-vertical. A primary care practice's Patient Recall and a specialty group's Prior Auth Bot run on the same backbone — different schemas, different EHR integrations (Athenahealth, Epic, eClinicalWorks, NextGen), different volume thresholds.
Numbers from MGMA, AMA, AHIP, and named-on-file practice manager interviews. Each leak paired to a BAA-eligible named agent.
Industry data: prior authorization turnaround averages 7–10 business days. First-pass denial rate: ~30% (specialty: ~40%). Each prior auth requires ~22 minutes of staff time on initial submission, plus another 40-60 minutes on appeals if denied. Multi-provider practices maintain 0.5–2 FTEs of dedicated prior auth staff. Lost revenue from procedures not performed because auth never came through: ~$2,400 per cancelled appointment.
Industry-average primary care no-show rate: 15–25%. Specialty: 8–15%. Average value of a no-show slot: $200–$300 in primary care, $450+ in specialty. Best-in-class practices using SMS reminders + automated waitlist filling cut no-shows by 40–60%. The leak isn't just lost revenue — it's underutilized provider capacity that compounds across the year.
Average claim re-work cost when insurance wasn't verified ahead of visit: $80 per claim. Industry-average insurance verification rate at point of service: ~72%. Best-in-class: ~95%. The 23-point gap on a practice billing $4M annually = ~$50K/year in claim re-work. Plus another $20K-$40K in patient bad debt when patients didn't know what they owed.
The JAMA Internal Medicine 2023 study: physicians spend 1.84 hours per day on EHR documentation outside scheduled hours ("pajama time"). At a $250/hr loaded cost per provider, that's $460/day per provider in opportunity cost — or $115K/yr per provider if that time were productive. Charting Assist (HITL only — never autonomous) cuts this by 40–60%.
Industry pattern: 22–30% of established patients are past due on annual physical, follow-up appointment, or chronic-disease management visit. Standard recall systems (postcards, manual phone calls) reach ~18% of those past-due patients. Multi-channel recall (SMS + email + voice) reaches ~52%. The gap on a 5,000-patient practice: ~1,400 missed visits/year × ~$220 average value = $30K-$80K.
Default Clinical Fleet ships with five (Patient Recall, Prior Auth Bot, Insurance Verifier, Schedule Sentinel, Guardian) plus expansion archetypes. Charting Assist runs HITL-only — the agent drafts; a licensed provider reviews and signs. No autonomous clinical documentation under any circumstance.
Reactivates past-due patients via SMS, email, and voice fallback. Books appointments directly into Athenahealth / Epic / eClinicalWorks. Cuts past-due reach rate from ~18% to ~52%.
Submits prior auths against payor portals (CoverMyMeds, payer portals, fax). Drafts appeals when denied. Reduces 30% denial rate to ~12%. Cuts staff time from 22 min/auth to ~6 min.
Verifies insurance eligibility 48 hours and 4 hours before visit via Availity / pVerify / Waystar. Flags coverage gaps. Drives verification rate from 72% to 95%+.
Never autonomous. Drafts SOAP notes, ICD-10/CPT coding suggestions, and patient communication from encounter recording. Provider reviews and signs every draft. Cuts pajama-time charting by 40–60%.
SMS + email reminders 2 days, 1 day, 2 hours before visit. Auto-fills cancellations from waitlist. Cuts no-show rate from 22% to ~11%. Patient SMS responses route to scheduler.
Answers when CSR can't. Schedules appointments directly. Routes urgent issues to on-call. BAA-executed Twilio HIPAA-eligible voice products only.
Daily briefing for practice owner / manager. Today's prior auth queue. This week's no-show rate. This month's recall reach. Quarterly trends against MGMA benchmarks.
HIPAA Privacy Rule + Security Rule compliance. Workforce training tracking. BAA flow-down management for sub-processors. Annual HIPAA risk assessment. State-specific medical privacy law tracking.
Every patient interaction, every prior auth justification, every payor relationship, every state-specific quirk — indexed and retrievable. Stored in pgvector self-hosted in LouDNAi VPC for PHI workloads.
Charting Assist, prior auth submissions involving clinical decisions, and any output that affects patient care passes through a Human-in-the-Loop gate that cannot be disabled by customer configuration. The gate is enforced in code, not policy. LouDNAi does not provide medical advice; agents draft, providers decide.
Live calculator launches v1.1. The DNA Scan replaces these with measurements from your Athenahealth / Epic / eClinicalWorks / NextGen EHR.
Every Clinical Fleet ships under an executed Business Associate Agreement. PHI workloads route only to BAA-eligible LLM tiers. No exceptions, no shortcuts.
Standard BAA in 7-14 days. Customer template accepted with 5-10 day legal review. Sub-processor BAA flow-down enforced.
BAA process →Anthropic Enterprise · OpenAI Enterprise · Google Cloud HIPAA-eligible. Zero data retention configured. PHI never to non-BAA tiers.
HIPAA architecture →Trust Services Criteria: Security, Availability, Confidentiality. Q3 2026 issuance.
SOC 2 disclosure →Clinical Fleet pricing reflects BAA-eligible LLM routing premium and HIPAA infrastructure costs. The DNA Scan funds itself.
Maps your operational DNA against Athenahealth / Epic / eClinicalWorks / NextGen. Quantifies recoverable dollars.
Premium reflects BAA infrastructure for single PHI-touching agent. Typically Patient Recall or Insurance Verifier.
Five to nine BAA-eligible named agents. Default for 4+ provider clinical practices. BAA executed before deploy.
One practice. Eight providers. $5M revenue. Recoverable: ~$255K/year. The DNA Scan tells you exactly which BAA-eligible agents recover it — in 21 days, for $9,500, fully credited toward Fleet within 60 days.