Concierge & DPC
Concierge members call frequently for prescription refills, prior authorization status, and insurance questions. These calls consume staff time but rarely require a provider decision. An AI receptionist captures the request, checks your EHR and formulary data, and either fulfills it or queues it for clinical review.
In a concierge practice, your clinical and administrative team handles a mix of clinical consultations, prior authorizations, and routine requests. Removing the high-volume, low-complexity calls from the queue means your team focuses on the work that requires judgment or relationships.
When a member calls for a refill and hears 'I'll capture that and route it to your clinical team for approval,' they feel heard and efficient. Refills that historically took 24–48 hours for staff to route and fulfill are now prioritized and processed faster.
Prior authorization requests are captured with all relevant details (patient, insurance, procedure/medication, urgency) and routed to the right person with context. No message left on voicemail. No miscommunication between staff.
Insurance questions answered on the call (with summaries reviewed by your team) mean members understand their responsibility before the visit. Fewer payment surprises lead to fewer billing disputes and collection delays.
Routine refills captured on call
Structured request logged for your approval workflow
Prior auth captured with context
All relevant details logged for your clinical team
Structured request summary
Insurance, medication, dosage, and pharmacy details in one place
HIPAA-compliant logging
All interactions documented for compliance and billing
The AI collects the member's request, confirms the medication and dose (pulling from your EHR), confirms the pharmacy, and logs the refill request with full context. Your workflow determines next: your clinical staff reviews the structured summary, approves or modifies the request, and submits to the pharmacy. The member receives confirmation from your team or the pharmacy when the refill is ready.
The AI captures the member's insurance information on the call and flags it for your prior auth team or billing staff. They review the call summary, check the insurance, and determine whether a prior authorization is needed. The member is informed of next steps via call summary or callback.
The AI pulls the member's medication list from your EHR when it recognizes the caller. If the medication list is current, the AI confirms the drug name and dose. If there's a discrepancy or new medication, your team is flagged to update the record.
The AI confirms the pharmacy contact information and documents it in the call summary. Your clinical staff or pharmacy coordinator then submits the refill to the pharmacy. The member receives confirmation from the pharmacy when the refill is ready.
The AI flags the request as requiring clinical review and routes it to a provider or clinical staff member with full context. Your team reviews the patient history and decides whether to approve, modify, or decline the request. The member is notified of the outcome.
Related
AI receptionist for concierge and dpc practices
Direct primary care practices depend on efficient handling of routine member requests.
Capability
Patient intake
Structured capture of member information and request details during the call.
Integration
EMR and EHR integrations
AI pulls member medication, insurance, and history from your EHR to handle requests accurately.
See how MedReception AI handles after-hours calls, scheduling, intake, and patient communication for medical practices like yours.
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