Prior authorization slows treatment.
Get the request right.
Most prior authorization paperwork starts as a blank insurer form on a prescribing physician's desk. The patient's records sit in a portal somewhere; the diagnosis sits in a chart somewhere; the medication list sits in a pharmacy somewhere. Health Agent composes the request letter from the patient record on file so the prescriber has a complete first draft instead of a blank form.
Add the medication that needs prior authorization, the diagnosis, and the prescribing physician. Health Agent composes a complete prior authorization request letter from the patient record on file — name, date of birth, member ID, conditions, medications, allergies, and clinical justification supplied by the prescriber. The prescribing physician reviews, edits, signs, and submits. The patient or caregiver does not submit on the prescriber's behalf; the goal is to give the prescriber a starting draft, not a blank form.
Six denial categories. Address them up front.
Commercial prior authorization denials cluster into six common categories. Each has a different evidence pattern that the request can pre-empt. Health Agent surfaces these categories before generating the letter so the prescriber can address the most likely rejection paths in the request itself rather than after a denial.
- Step therapy The insurer requires cheaper or older medications be tried first. Pre-empt with: documented prior trials, intolerance, contraindication, or treatment failure already in the record.
- Not medically necessary The insurer disputes that the treatment is clinically required for this patient. Pre-empt with: clinical notes, lab values, specialty-society guidelines, prescriber's medical-necessity rationale.
- Experimental or investigational The insurer claims the treatment is not standard of care. Pre-empt with: peer-reviewed studies, specialist letter, FDA labeling, clinical-guideline citations.
- Formulary exclusion The medication is not on the plan formulary. Pre-empt with: a formulary-exception request grounded in medical necessity for the specific patient.
- Quantity limit The insurer caps the dispensed quantity below what was prescribed. Pre-empt with: clinical justification for the higher quantity, dosing rationale, prescriber attestation.
- Off-label use The medication is prescribed for an indication not on the FDA label. Pre-empt with: peer-reviewed support for the off-label use, specialty-society endorsement, prescriber rationale.
Health Agent does not promise approval. The insurer makes the coverage decision. The aim is a request that does not stall on a missing data point or fail on a category the prescriber could have addressed in the original letter. Health Agent does not provide legal advice; for external review, ERISA escalation, or state Department of Insurance complaint, retain qualified counsel familiar with health-insurance appeals.
Four steps. The prescriber stays in control.
- 1. The patient record is on file. Diagnoses, active conditions, current medications, known allergies, primary prescriber, and insurance card live in the patient's account. Records can be uploaded as photographs or pulled via FHIR R4 connectors — SMART-on-FHIR for Epic MyChart, Oracle Health (Cerner), and athenahealth; OAuth2 for Medicare Blue Button 2.0.
- 2. Add the medication and the diagnosis. The medication that needs prior authorization, the diagnosis driving the prescription, and the prescribing physician are entered. The clinical justification field receives the prescriber's medical-necessity rationale.
- 3. The request letter is composed. The patient's full name, date of birth, member ID, insurer, prescriber, requested medication, diagnosis, active conditions, current medications, allergies, and the prescriber's clinical justification are composed into a complete prior authorization request letter addressed to the insurer. The output is a structured draft, not a filing.
- 4. The prescriber reviews, edits, signs, and submits. The draft is shared with the prescribing physician for review, revision, signature, and submission to the insurer. A copy is saved in the patient's record so the same data does not have to be re-entered for the next request. Health Agent does not submit the request on anyone's behalf.
Health Agent is a Bonis Systems platform.
Health Agent is software for patients and family caregivers, operated by Bonis Systems LLC, a Wyoming-registered firm. The platform is independent of every health plan, pharmacy benefit manager, and Medicare Advantage organization — there are no carrier endorsements and no carrier partnerships. The patient owns the data; Health Agent acts on the patient's behalf under the patient's own access rights.
The Bonis cryptographic audit-permanence primitive — Knox — is shipped on the same platform and anchors evidence on TerraVault, TrustAi, and DealMatcher. On Health Agent the Knox chain anchors documents that enter through the appeals pipeline; see the Medicare appeals page for the operative description of the audit chain. Knox is the Bonis cryptographic audit-permanence primitive, USPTO provisional 64/038,359.
Common questions from patients and caregivers.
Does Health Agent submit the prior authorization for me?
No. Health Agent drafts the prior authorization request letter from the patient record on file. The prescribing physician reviews, edits, signs, and submits to the insurer. Health Agent does not file on the prescriber's or patient's behalf and does not act as a legal representative.
What goes into the request that Health Agent drafts?
The patient's full name, date of birth, member ID, insurer, primary prescriber, the requested medication, the diagnosis, the active conditions on file, the current medication list, known allergies, and the clinical justification supplied by the prescriber. The output is a structured letter the prescribing physician can revise and sign rather than a blank form.
Is Health Agent endorsed by any insurer?
No. Health Agent is operated by Bonis Systems LLC, an independent Wyoming-registered firm. There is no endorsement, affiliation, or partnership with any commercial health plan, pharmacy benefit manager, or Medicare Advantage organization.
How is patient data protected?
Traffic is HTTPS-only with HSTS preload (max-age 2 years, browser preload-list eligible). Object storage applies the cloud provider's default AES-256 at-rest encryption. The patient owns the data and can delete it from the account at any time. See the privacy policy at /privacy.html for the full data handling description.
Does Health Agent give legal advice?
No. Health Agent is software that drafts prior authorization request letters from the patient record. It is not a law firm, does not employ attorneys, and does not provide legal advice. For an external review, ERISA bad-faith claim, or state Department of Insurance escalation, retain qualified counsel familiar with health-insurance appeals.
What if the prior authorization is denied?
Most commercial plans offer a second internal appeal, then external review by an independent third-party reviewer. Self-funded ERISA plans follow ERISA §503 procedures rather than state external review. The denial response can be saved into the patient's record alongside the original request so the timeline and the insurer language are both preserved.
What does it cost?
Account creation is free. Tiered pricing for paid features is published at /pricing.html.
A complete first draft beats a blank form.
Account creation is free. Add the patient record. Add the medication and the diagnosis. Health Agent composes the prior authorization request letter; the prescribing physician reviews, edits, signs, and submits.