Operational Challenge
Prior authorization holds block your procedure schedule and frustrate patients. MedReception's AI captures insurance status and prior auth needs during the booking call, immediately flags your authorization team, and returns all details as a structured summary for your team to review and file—so appointments don't slip and patients stay informed.
The procedure is booked immediately (pending auth) so your provider's block time isn't wasted. Your authorization team tackles the insurance request while the slot is held for the patient.
The AI captures the patient's insurance info and procedure code, flags the call for your auth team, and reassures the patient their appointment will be confirmed once auth comes through.
Every insurance-pending appointment generates an instant flag with patient demographics, insurance, procedure code, and requested date—so your team starts the auth process without delay.
The AI explains that the appointment is booked pending insurance approval and tells the patient you'll confirm within a specific timeframe. No surprise cancellations.
Insurance captured on booking
Insurance card info, coverage details, and prior auth requirements flagged in real time for your authorization team
Appointment synced immediately
Procedure booked 'pending prior auth' in your EMR with a flag that your team monitors daily
Authorization team notified
Instant flag sent to your authorization staff with patient, procedure, insurance, and requested date
Patient communication consistent
Patients told their appointment is pending insurance approval and given an expected confirmation timeline
Yes. MedReception is HIPAA-compliant. The AI captures insurance card front/back, group number, and member ID during the call and returns the data encrypted for your team to review and process. The information is provided as a structured summary for your authorization team.
The AI asks about the procedure type and flags the call with the procedure code and your clinic's typical auth requirements. Your authorization team uses this to expedite the auth request to the insurance company.
Once your team approves the authorization, they mark the appointment 'confirmed' in your EMR. MedReception can trigger an outbound confirmation call to the patient with the green light and final appointment details.
Your authorization team notifies MedReception of the denial, which triggers a cancellation call to the patient. The AI offers alternative options (appeal, self-pay, different procedure) and reschedules if appropriate.
No. The AI pre-fills the authorization request with patient and procedure data, reducing manual data entry. Your team reviews the flagged appointment, contacts the insurance, and updates the status—a streamlined workflow.
Workflow
Patient intake
How MedReception captures insurance and demographic data during calls and returns it for staff review.
Integration
EMR and EHR integrations
How appointment bookings and authorization flags sync to your pain management EMR in real time.
Security
HIPAA and compliance
How MedReception securely captures and handles insurance information on calls.
See how MedReception AI handles after-hours calls, scheduling, intake, and patient communication for medical practices like yours.
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