Concierge & DPC

AI receptionist routes prior authorization requests directly to your PA coordinator

Prior auth calls can derail your schedule. An AI receptionist captures authorization requests, identifies the insurance carrier and procedure code, and routes the call to your PA coordinator—freeing clinical staff for member care.

How it pays back

Urgency Preserved

Time-sensitive prior auth requests (pre-op authorizations, urgent imaging) are routed immediately to your PA coordinator rather than queuing in voicemail or waiting for call-back.

Structured Data Capture

Insurance carrier, member ID, procedure, and request timeline are captured during the call. Your coordinator has full context before picking up the phone to the insurance company.

Provider Focus Maintained

Your clinician doesn't field prior auth calls. The AI routes these administrative requests to the appropriate staff, protecting clinical time for member care.

Tracking and Follow-Up

All PA requests are logged in your EHR with status updates, so nothing slips through during the authorization period.

Prior auth calls routed

Directed immediately to PA coordinator without queuing

Insurance details captured

Carrier, member ID, procedure, and urgency extracted from caller

Request logged and tracked

Full audit trail in your EHR from call to approval

Coordinator efficiency improved

Full context available before insurance company callback

Frequently asked questions

How does the AI identify which procedure requires prior authorization?

The AI asks the caller for the procedure name or type (e.g., MRI, injection, surgery). Based on the procedure and member's insurance, the AI can apply your practice's prior auth rules to route appropriately.

Does the AI capture insurance information during the PA request?

Yes. The AI captures insurance carrier, member ID, and group number. This information is returned as a structured summary for your PA coordinator to use when contacting the insurance company. Insurance details are captured on the call and returned in a structured summary for your staff to review and file.

What if the prior auth request is urgent?

The AI identifies urgency flags (pre-op within 48 hours, symptom severity) and escalates the call immediately to your PA coordinator or clinical staff. Urgent requests are not queued.

Can the AI follow up with members on PA status?

Yes. You can configure the AI to send follow-up notifications to members once authorization is approved or if additional information is needed from the member.

Related reading

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Prior Authorization Routing for Concierge and DPC Practices | Medreception AI