New solution delivers real-time, unlimited eligibility verification and helps practices prepare for CMS’s 2026 mandate.

SPRY Therapeutics Inc. today announced the launch of the SPRY Prior Authorization & Eligibility Solution, the first AI-powered solution purpose-built for rehab therapy clinics. The solution automates up to 80% of prior authorization workflows while ensuring all authorizations are completed through a combination of AI automation and expert review. It reduces related denials by up to 75% and provides real-time, unlimited eligibility verification while streamlining processes across major payers, including Carelon/BCBS, UnitedHealthcare, and Humana.

SPRY’s solution arrives at a critical juncture as rehab therapy clinics prepare for CMS’s 2026 electronic prior authorization mandate. The platform’s FHIR-compatible APIs support integration with evolving electronic authorization requirements. AI agents manage the end-to-end authorization workflow, from reading clinical documentation to submitting requests and securing approvals, while processing authorizations up to a week before scheduled appointments. This advance timeline gives clinics the opportunity to resolve discrepancies before patients arrive. Real-time checks support walk-ins and help reduce last-minute cancellations.

“Prior authorization is mission-critical for patient care—when it fails, patients can’t receive treatment and practices lose revenue,” said Brijraj Bhuptani, cofounder and CEO of SPRY. “We already have therapy practices live on our platform where our AI reads therapist documentation, completes payer medical questionnaires, and secures authorizations up to a week before patients arrive. These clinics haven’t had authorization-related appointment cancellations in months. The future isn’t about tracking authorizations, it’s about AI that executes the work so therapists can stay focused on what they do best: treating patients.”

AI Agents Execute Complete Authorization Workflow

SPRY’s custom AI agents manage the end-to-end authorization workflow, from determination through approval, reducing manual intervention for most cases while proactively identifying expiring authorizations and initiating renewals before they affect patient care. The platform incorporates integrated verification protocols with automated audit trails to ensure accuracy prior to submission. The automation adapts to handle complex authorization scenarios and payer website changes automatically. To maximize accuracy, SPRY uses a human-in-the-loop quality assurance layer, ensuring all cases are validated before submission, so clinics benefit from both automation speed and expert oversight.

The system runs eligibility checks automatically at scheduling, with built-in verification that flags suspicious values for quick review. SPRY’s therapy-specific rules engine understands requirements such as visit caps and modality limitations, with nightly re-verification performed for plans subject to mid-month changes.

The platform works seamlessly within SPRY’s EMR or as a standalone service connected to third-party EMRs, enabling clinics to manage authorizations and eligibility from a single dashboard without portal-hopping.

Early Adopters Report Significant Operational Improvements

Renew Physiotherapy achieved denial rates of just 0.57% over two months of live operation while automating 75% of its authorization workflow.

“We used to have staff spending hours a day calling insurance companies, dealing with the frustration of being on hold and getting different answers from different representatives,” said Samantha Strickland, physical therapist and co-owner at Ultimate Therapy. “With SPRY, that workload has been cut dramatically, and we get approvals much faster. Beyond the efficiency, it feels like such a relief to have SPRY on our side as a smaller practice. I now feel like I have the expertise of a bigger player helping us go head-to-head with insurance companies to get reimbursed what we’re supposed to.”

Platform performance metrics validate these results:

• 99% of eligibility files processed in under one hour
• 95%+ eligibility match rate across major payers
• 80% reduction in administrative burden related to authorization tasks
• 95% reduction in authorization submission time (1.5 minutes with AI vs. 20+ minutes manually)

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

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The post SPRY Launches AI Solution Automating 80% Prior Auth for Rehab Clinics first appeared on AI-Tech Park.

Origianl Creator: Business Wire
Original Link: https://ai-techpark.com/spry-launches-ai-solution-automating-80-prior-auth-for-rehab-clinics/
Originally Posted: Mon, 15 Sep 2025 16:15:00 +0000