Transform prior authorization review with automation and orchestration

The UiPath Solution for prior authorization orchestrates intake, validation, clinical review, and determination so utilization management teams review more cases and meet CMS turnaround mandates.

Healthcare orchestration and automation: smarter workflows for better patient outcomes

See how payers and providers use agentic AI to compress administrative work across claims, prior authorization, and clinical documentation, with clinicians in the loop.

Transform the work behind care, with clinicians in charge

Healthcare orchestration coordinates intake, eligibility, and clinical review across payer and provider workflows, while clinicians make every patient-impacting call.

85%
of healthcare leaders will increase agentic AI investment in the next 2–3 yearsDeloitte, 2026
30–60%
reduction in cost to collect from AI-enabled revenue cycle managementMcKinsey & Company, 2026
95%
of healthcare leaders said GenAI will be transformative for their organizationBessemer Venture Partners, 2025

Healthcare agentic solutions, ready to deploy

Purpose-built solutions deploy on the UiPath Platform, orchestrating AI agents, robots, and clinicians across payer and provider workflows.

Ready to deploy

UiPath Solution for prior authorization

Faster approvals, fewer denials, less abrasion

Universal intake captures requests from fax, portal, EDI/API, and call center. UiPath IXP extracts request data and flags missing clinicals. Agents summarize medical records, surface evidence against payer policy, and route cases to RNs and medical directors for human-in-the-loop review.

  • Universal intake across all channels
  • AI-summarized clinical evidence
  • Meets CMS 72-hour/7-day turnaround
  • RN/MD review in Action Center

Ready to deploy

UiPath Solution for claim denial prevention and resolution

Prevent denials. Protect revenue.

Detect incomplete patient information, eligibility gaps, credentialing issues, and missing pre-auths before claims are submitted. When denials happen, Autopilot drafts compliant appeals with supporting evidence, and Maestro orchestrates corrections across your RCM systems.

  • Detect denial causes pre-submission
  • Autopilot-drafted appeals
  • Pattern analysis across payers
  • Audit-ready every step

Ready to deploy

UiPath Solution for medical record summarization

Trusted summaries, built to scale

Clinical process owners define summary templates aligned to their workflows. The UiPath DeepRAG framework synthesizes multi-modal records into evidence-based summaries with in-text citations. Built-in HITL review and feedback loops continuously improve quality.

  • DeepRAG with in-text citations
  • Clinical owner template control
  • Side-by-side reviewer interface
  • Quality and ROI metrics per workflow

Healthcare workflow automation use cases

Beyond the ready-to-deploy solutions, healthcare process orchestration extends across revenue cycle, patient access, and clinical documentation workflows.

Claims & revenue cycle

Claims processing and revenue cycle

Healthcare process orchestration accelerates every step of the revenue cycle. Agents audit high-dollar claims, resolve pending claims, and shorten appeals and grievances turnaround time, while clinicians and billing teams handle the calls that need human judgment.

Patient access

Patient scheduling and prior authorization

Agents validate eligibility, determine whether prior auth is required, route requests by payer policy, and surface evidence to nurses and medical directors so determinations happen before care is delayed.

Clinical documentation

EHR data entry and clinical documentation

Healthcare process orchestration removes the EHR keystrokes that drive burnout. Agents read multi-modal records, generate evidence-based summaries with in-text citations, and write outcomes back to the system of record after a clinician review.

Trusted by 8 of the top 10 global healthcare firms

CareSource black logo
OSF Healthcare logo
Hackensack Meridian Health logo
VSP Vision logo
NHS logo
CareSource black logo
OSF Healthcare logo
Hackensack Meridian Health logo
VSP Vision logo
NHS logo
A nurse and a senior doctor reviewing patient information on a tablet in a dim hospital corridor, representing healthcare workflows that UiPath agentic automation and AI agents help simplify for clinical teams.

The UiPath Platform™ for healthcare orchestration and automation

Healthcare process orchestration and automation runs on the UiPath Platform, built for HIPAA-regulated environments. Governance, audit-ready execution, and EHR integration are native to the platform.

HIPAA-aligned governance

Pre-hardened for HIPAA, SOC 2 Type II, GDPR, and FedRAMP, with audit trails on every action.

Connects to your EHR

Integrates with Epic, Cerner, Meditech, and your payer systems without replacing them.

Human-in-the-loop by default

Clinicians, RNs, and case managers stay in charge of every patient-impacting decision.

Explore the full UiPath Platform

The UiPath Platform brings business process orchestration, automation, governance, and testing into one system, built for the most regulated healthcare workflows.

See healthcare orchestration and automation in action

Healthcare leaders from payer and provider organizations share how process orchestration and automation are driving measurable outcomes.

Healthcare payers drive ROI from agentic AI

Payers

Healthcare payers drive ROI from agentic AI

Leaders from Cigna, Arkansas Blue Cross Blue Shield, Blue Cross NC, and Blue Cross Blue Shield of Arizona on transforming payer innovation and efficiency.

See more

Healthcare leaders getting results with UiPath

Payers, providers, and the health systems behind them share what healthcare orchestration and automation are delivering in production.

Case study

Medlitix transformed the most time-consuming part of clinical review, moving from 70 minutes per summary to six while scaling without adding clinical hires.

  • 90%

    reduction in clinical review time per case

    95%

    accuracy achieved with initial AI-generated summaries

    $1.2M

    estimated savings from avoiding five additional clinical hires

  • 90%

    of invoices processed automatically

    50%

    reduction in manual labor

    98.5%

    auto-adjudication rate for claims, up from 92%

  • 18

    processes automated

    £370K

    manual effort saved a year

    56

    hours a day saved in clinical settings

Hear from healthcare automation leaders

Payer and provider executives on what changes when agents, robots, and clinicians run on one governed platform.

Satendra Shukla
"Agentic automation is certainly on our agenda for facilitating two key use cases—device processing and medical summarization. With agentic automation, we can potentially enhance our device processing capabilities. Similarly, we intend to use agentic automation to efficiently manage extensive medical records via summarization."

Satendra Shukla

Vice President, Payer Configuration & Intelligent Automation, CareSource

Go deeper on healthcare orchestration and automation

See all healthcare resources

stacks of paper

White paper

Cut costs and accelerate claims processing with orchestration and automation

Manual processes and outdated systems slow claims operations. The UiPath Platform for business orchestration and automation is the key to reducing costs and speeding up claims resolution.

Read white paper
Two scientists in protective gowns, masks and gloves examining a sample vial in a pharmaceutical laboratory, representing life sciences and research workflows that UiPath agentic automation and AI agents accelerate.

Webinar

From gaps to gains: how automation transforms care gaps management

Missed screenings and overdue follow-ups can lead to serious complications, poor outcomes, and lower compliance ratings. See how healthcare teams use business orchestration to close care gaps at scale.

Watch the webinar
Smiling doctor reviewing a chart with a mother holding her young child in a bright clinic exam room, depicting patient care and healthcare workflows that UiPath agentic automation and AI agents help streamline.

Webinar

Revenue cycle transformation at Mayo Clinic and UT Southwestern

Leading health systems share how they are reducing denials, accelerating cash flow, and freeing up staff time. Recorded at Becker’s Healthcare Virtual RCM Summit.

Watch the webinar

Healthcare automation FAQs

Common questions about healthcare orchestration, healthcare workflow automation, and how agentic AI works alongside the systems your organization already runs.

  • Healthcare automation uses software to handle the administrative and clinical workflows that traditionally require manual work: claims processing, prior authorization review, medical record summarization, eligibility checks, and revenue cycle tasks. Modern healthcare automation combines AI agents that make recommendations with automation that executes the resulting work across EHRs, payer systems, and care management platforms.

  • Healthcare workflow automation coordinates the steps of a clinical or administrative process across systems, AI agents, and people. Instead of one robot completing one task, workflow automation in healthcare runs whole arcs end to end: intake, eligibility, clinical review, decision, and writeback to the EHR, while keeping clinicians in the loop where judgment is required.

  • Business orchestration coordinates AI agents, automation, and people to complete long-running healthcare workflows end to end. In practice, a single control plane can run the whole arc of a prior authorization or claim denial, from intake through clinical review to resolution, while keeping clinicians and case managers in the loop for every decision that requires judgment.

  • The UiPath Platform combines RPA, AI agents, intelligent document processing, and Maestro orchestration inside a HIPAA-aligned governance layer. Robots and agents handle intake, extract data from faxes, portals, and EHRs, apply business rules, surface evidence to clinicians for review, and write outcomes back to the system of record. Every step is observable, auditable, and governed.

  • The UiPath Platform is pre-hardened for SOC 2 Type II, GDPR, HIPAA, and FedRAMP. Role-based access, audit trails, and human-in-the-loop checkpoints are built into every automation. Healthcare teams can deploy on-premises, in a dedicated cloud, or in a sovereign region to meet data residency and regulatory requirements.

  • Most payers and providers see the fastest impact on denial-heavy, documentation-heavy workflows: prior authorization, registration and eligibility, medical record summarization for utilization management, and claims appeals. UiPath ships ready-to-deploy solutions for prior authorization, claim denial prevention and resolution, and medical record summarization to shorten time to value.

  • UiPath is trusted by 8 of the top 10 global healthcare firms. Customers include CareSource, Medlitix, the National Health Service, OSF Healthcare, Hackensack Meridian Health, VSP Vision, AGS Health, Cigna, and Blue Cross Blue Shield plans across multiple states.

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