Concierge & DPC

Let your AI receptionist capture prior auth requests and administrative calls so your staff focuses on member care

Concierge members call for prior authorizations, refills, test results, and appointment changes. An AI receptionist captures these requests, routes them to the right team, and keeps member satisfaction high by eliminating hold times.

Member calls for prior auth, refill, test result, or appointment change—AI answers immediately
Capture request type, relevant medical context, and member preference for callback timing
Route to clinical staff (prior auth, refills), billing (insurance questions), or scheduling (appointment changes)
Member confirmation and callback window set on the same call—no follow-up needed
All requests logged to your EMR for audit trail and continuity
Member perceives seamless service; your staff handles the request without administrative handoff

How it pays back

Routine requests don't clog your phone lines

Prior auth requests, refill inquiries, and test result checks are captured asynchronously on AI, so your clinical and billing staff aren't interrupted by routine calls. They review and action requests on their schedule.

Member satisfaction stays high without adding staff

Members don't wait on hold because the AI captures the request in real time. Your staff handles the actual work offline, and the member gets a callback window instead of a lengthy hold.

Prior authorizations move faster

The AI captures the specialty, medication, dosage, and insurance details on the first call. Your billing or clinical staff don't have to call back asking for clarification—they action the auth immediately.

Audit trail and compliance are automatic

Every request is logged to the EMR with timestamps. Prior auth requests, refill approvals, and callbacks are all documented without staff lifting a finger.

Every call answered

No hold queue, no callback tag—requests captured immediately

Structured request captured

Prior auth details, medication, dosage, insurance, member contact preference all on file

Routed to right team

Clinical staff get prior auth and refill requests; billing gets insurance questions; scheduling gets appointment changes

Logged to EMR

Full audit trail and compliance documentation automatic

Frequently asked questions

How does the AI know whether a request is truly routine or needs urgent attention?

We configure urgent triggers during setup. If a member mentions symptoms that warrant immediate clinical review (e.g., new rash before dermatology visit), the AI flags it as urgent and routes to the on-call clinician. Routine refills and prior auth requests go to your regular workflow.

Can the AI verify insurance coverage while the member is on the phone?

The AI can capture insurance details and past coverage from your EMR, but real-time eligibility verification happens through your usual insurance portal. The AI front-loads the call so your billing team has all context when they check coverage.

What if the member needs to speak to a clinician about a refill (e.g., they've run out early)?

The AI captures the reason for early depletion and routes it to your clinical staff with a flag for clinical judgment. Your nurse or provider can then review and make an informed decision without the member waiting on hold.

How do we ensure members get their callback within a reasonable timeframe?

The AI confirms the preferred callback window when capturing the request (e.g., "I'll have billing call you between 2–4 pm"). Your team receives the request in your workflow queue and follows up within that window. The member knows to expect a call, so no surprise waits.

Does the AI need to know about all our members' medical histories to handle these calls?

The AI has read-only access to your EMR (if integrated). It can see past medications, allergies, and recent visits to provide context on refill or prior auth requests. Your staff always has full detail when they action the request.