Prior Authorization. A production blueprint.
A 10-week prior authorization agent for payers. Reads policy, gathers clinical evidence, drafts the determination. ADK, Memory Bank, Agent Registry, Model Armor.
The outcome.
- What it does
Prior-auth turnaround from 7 days to under 24 hours.
Reads the medical policy, gathers the clinical evidence from the EHR, drafts the determination with the rationale already written. Borderline cases route to a human reviewer.
- Who it serves
Payer operations, the Medical Director, the provider.
VP Claims Ops gets a measurable lift in turn-around. Providers get faster decisions, with documented rationale.
- Business KPI
Turn-around time and reviewer capacity.
Median turn-around drops from 7 business days to under 24 hours on clean cases. Reviewer capacity reallocates to the borderline tier.
Components used.
HIPAA-eligible Google Cloud services only for PHI persistence: Cloud SQL, AlloyDB, Cloud Storage. Memory Bank holds non-PHI session context only.
ADK Python v1.32
Agent Development Kit. The agent ships as ADK code your team owns and deploys.
Model Armor
PHI redaction enforced at the gateway between data plane and any model call.
Agent Registry
Versioned audit trail of every decision, every hand-off, every reviewer action.
Cloud SQL · AlloyDB
HIPAA-eligible relational stores under your BAA. Region-pinned at deploy.
Cloud Storage
HIPAA-eligible object store for documents and attachments. CMEK-encrypted.
Memory Bank
Non-PHI session context only. PHI does not persist in Memory Bank.
IAM & Workload Identity
Per-agent service accounts. Scoped to the providers and stores the blueprint actually touches.
BigQuery
Audit retention exported under retention policy your compliance team controls.
Persona.
The CMO and clinical leadership care about patient safety and clinician trust first, throughput second. Every recommendation is review-first; the clinician signs.
The operations leader cares about cycle time and exception ratios. The blueprint routes the clean cases automatically and queues the borderline cases with the rationale pre-drafted.
The CIO cares about risk posture and architectural ownership. Deployment runs in your tenancy, on HIPAA-eligible Google Cloud services, under your BAA. You own the code, the data planes, and the audit.
Timeline. 10 weeks.
The 6-week pilot methodology, extended to 10 weeks for the additional compliance review and integration depth.
Talk to the healthcare practice.
Two business days to a named SE on the call. We sign a BAA before any engagement that touches PHI.