The Agent Health Insurance Protocol (A2H) is a new, domain-specific layer that enables secure, compliant, and fully auditable collaboration between intelligent software agents used by payers, providers, brokers, and members in healthcare. Essentially, it's a "universal language of verification" for agent-led interactions, such as those involved in prior authorization.
While other protocols allow agents to understand and communicate, A2H provides the missing framework for identity, authorization, and auditability for every interaction.
The protocol solves the challenge of compliance and accountability for intelligent agents by establishing a trust layer built on three components:
1. Verifiable Credentials (VCs): Each agent carries digitally signed credentials—like an NPI for a provider or a state license for a broker—which are anchored in a verifiable identity registry. This ensures that only authorized entities can act.
2. Mandates: A mandate is a digitally signed instruction that clearly defines who is acting, on whose behalf, what action is authorized (e.g., submitting a prior authorization), and within what limits.
3. Signed Conversations: Every single exchange, whether automated or manual, is packaged in a cryptographically signed A2H envelope. This creates a tamper-proof chain of custody and a single, immutable audit trail.
A2H transforms complex, manual healthcare workflows like prior authorization from a "black box" into a transparent, verifiable conversation. This structured approach delivers significant value to both Payers and Providers.
| Business Outcome | Value & Cost Savings |
|---|---|
| Faster Turnaround Times | For example, Prior authorization, which traditionally takes weeks, can be reduced to hours or minutes with traceable approval. This reduces administrative operating costs for both sides. |
| Reduced Denials and Appeals | The system automatically identifies policy criteria gaps and generates structured, machine-readable follow-up questions. This allows providers to quickly supply the exact missing evidence, leading to fewer initial denials and reducing costly appeal processes. |
| Full Compliance and Auditability | The cryptographically signed evidence chain provides a verifiable audit log of every action, including reviewer decisions and policy references. This helps health systems comply with regulatory frameworks like CMS, HIPAA, and state DOI rules. |
| Optimized Manual Review | A2H structures human review, ensuring reviewers see the same policy-aligned data and AI reasoning. Every human decision is signed, timestamped, and recorded, turning manual review from a cumbersome fallback into a defined, auditable protocol step. |
| Transparency and Trust | Instead of fragmented portals and PDFs, agents use a unified exchange with transparent policy logic. The clear reasoning and policy references provided for the final decision build trust between payers and providers. |
A2H enables human and AI collaboration by structuring human judgment and ensuring that all agent-led interactions are traceable, compliant, and fully explainable. This leads to faster decisions, reduced friction, and significant operational efficiency for all parties.
Vinay Nadig serves as the President of SimplifyX. He is relentlessly focused on enabling his customers to solve hard problems using Agentic AI. He brings decades of leading teams in architecting, building and implementing real solutions to achieve real business outcomes.
