Workflow
Prior authorization delays block interventional pain procedures and frustrate patients. AI reception captures payer requirements, procedure codes, and clinical justification during scheduling calls—giving your auth team everything they need immediately.
Your prior authorization team receives a structured summary with procedure type, codes, patient demographics, and payer info. No second call needed to clarify.
New-to-practice patients, complex procedures, or out-of-network submissions are marked for manual auth review before the appointment is confirmed. Your team manages risk proactively.
The AI logs whether the patient has already called their payer or your clinic has contacted them. Your staff sees that history and avoids redundant calls.
You know before scheduling day whether authorization is pending, approved, or missing. Schedule accordingly or hold pending resolution.
Prior auth requirements identified at booking
Complete intake data for your auth team
Payer contact history captured
No duplicate authorization calls
Procedure codes captured in summary
Auth team works from complete data
High-risk cases flagged for review
Proactive auth management
You configure which procedures your payers typically require authorization for. The AI asks the relevant questions and flags those cases. Your auth team still owns the verification—this just makes their intake complete.
Yes. You set rules—e.g., 'Flag all out-of-network commercial plans' or 'Manual review for new Medicaid patients.' The AI applies those rules and marks cases accordingly.
The AI captures whatever information is available and flags the case as 'insurance pending.' Your staff follows up before the procedure, or you can confirm on the call back.
The AI returns structured summaries to your team; many prior auth platforms can ingest that data via API or manual entry. Your IT or vendor can advise on direct integration options.
See how MedReception AI handles after-hours calls, scheduling, intake, and patient communication for medical practices like yours.
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