Referral Workflow

Route radiculopathy cases to orthopedics, neurology, or pain management; capture referral details on first call

When a caller reports low back pain with leg weakness, the AI determines if the case should go to orthopedic surgery, neurology, or interventional pain management. Capture insurance and referral needs, then book the appropriate specialist appointment.

How it pays back

Right Provider, First Try

Instead of booking orthopedics and later discovering the patient needs EMG or pain injections, the AI asks about treatment goals and guides to the appropriate specialist. Reduces transfers and repeat appointments.

Insurance Details Captured

On the call, the AI collects insurance information and documents whether the specialist is in-network. Staff know upfront if prior authorization may be required; the AI returns these details for staff to handle.

Specialist Intake Pre-Filled

Referral reason, symptom timeline, imaging history, and prior treatments are captured in one call. When the specialist receives the patient, the intake summary is ready for staff review and filing.

Urgent Cases Flagged

Callers with red flags (foot drop, severe weakness, progressive symptoms) are routed to same-day or next-day urgent specialist slots; stable chronic radiculopathy goes to routine scheduling.

Specialist routing decision made in call

Orthopedics, neurology, or pain management selected based on clinical presentation

Insurance and referral details captured

Coverage and authorization status documented for staff follow-up before specialist visit

Referral paperwork streamlined

Provider name, contact, and clinical summary captured and returned as a structured summary for specialist handoff

Frequently asked questions

How does the AI know whether to route to orthopedics, neurology, or pain management?

The AI asks: Are you experiencing weakness or numbness in your leg? Have you tried physical therapy or anti-inflammatory medications? Are you interested in a nerve block or injection, or would you prefer evaluation for possible surgery? Answers guide the specialty.

What if the patient's insurance requires prior authorization for the specialist?

The AI captures insurance details and documents whether the specialist is in-network. Staff receive this information and initiate prior authorization before the specialist appointment.

How does the referral information flow to the specialist's office?

The AI returns referral reason, imaging summary, symptom timeline, and prior treatments as a structured intake summary. This is sent electronically to the specialist's office (if integrated) or printed for the patient to carry.

Are urgent radiculopathy cases prioritized?

Yes. Any caller reporting foot drop, severe bilateral leg weakness, or progressive neurological symptoms is routed to same-day or next-day urgent specialist availability. Stable chronic cases go to routine scheduling.

Related reading

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