Workflow

AI-powered member verification and call screening for concierge practices: confirm status and route in one call

Concierge practices depend on rapid member identification and routing. MedReception AI confirms membership in real time and routes calls based on member type, urgency, and preferred physician—eliminating caller hold times and missed context.

Real-time membership lookup against EMR (Elation, SimplePractice, Tebra, athenahealth) to verify active status
Ask for member ID, phone, or date of birth; pull past visit history and known preferences
Route established members differently than prospective members or non-members
Capture reason for visit, symptom severity, and any clinical red flags for triage
Flag urgent or acute calls for escalation to on-call provider without delay
Return structured summary to staff so receptionists inherit full context, not just a name and number

How it pays back

One-Call Confirmation

Caller doesn't repeat information across departments. AI confirms membership and routes in a single conversation, eliminating transfer delays and caller frustration.

Context-Rich Handoff

Staff see member status, recent visit date, current provider assignment, and stated reason for call. They can engage immediately without re-screening.

Tiered Routing Logic

Established members route to their provider or care team. New prospects route to intake or sales. Urgent symptoms trigger on-call escalation. Each call follows its most efficient path.

Non-Members Handled Gracefully

Callers who aren't members are offered membership information or directed to prospective member intake—no dead ends or bounced calls.

EMR membership lookup

Instant verification without staff intervention

Tiered call routing

Members, prospects, and urgent callers each route appropriately

Reason for visit capture

Clinical context prepared for handoff before staff answer

Escalation flagging

Acute calls identified and routed to on-call provider

Frequently asked questions

What if a caller isn't in the membership database?

The AI offers new patient intake or membership information. You can configure it to take a name and number for callback, or route to your concierge coordinator for a sales conversation. Non-members don't hang up confused.

How does the AI know which provider a member sees?

Your EMR maintains primary care physician and preferred provider assignments. When the AI verifies membership, it pulls that assignment and routes accordingly. If the caller requests a different provider, the AI notes that and flags it for staff.

Can member preferences (telehealth preference, language, billing) influence routing?

Yes. If your EMR stores preference flags (e.g., 'Spanish-speaking', 'prefers telehealth', 'billing flag'), the AI can read those and route or flag appropriately. Custom logic can be configured by your team.

What happens if the EMR is down or slow?

The AI has fallback protocols: ask for name, date of birth, and member ID verbally. If lookup fails, it captures caller info and routes to your team with a note that verification couldn't be confirmed. Staff can complete verification and route.

Does the AI capture the member's reason for calling?

Yes. After verifying membership, the AI asks 'What can we help you with today?' and captures open-ended or structured responses (appointment, prescription, urgent concern). That context is returned as a structured summary for staff review.