Administration

AI captures insurance and prior authorization questions from members, routes to staff for completion

Concierge members often call with insurance or billing questions. AI captures these inquiries in structured format and routes them to your billing or administrative team, keeping your front desk free.

Insurance question capture: member inquires about coverage, deductible, or co-pay—AI documents the question and member intent
Prior authorization requests: member or provider office calls requesting prior auth for upcoming procedure, AI initiates intake and alerts billing staff
Claim and EOB inquiry: member asks about claim status or explanation of benefits, AI gathers context and queues for billing review
Referral authorization questions: member asks if referral is authorized or needed, AI captures intent and routes to care coordinator
Billing dispute escalation: member disputes a charge, AI listens and documents the issue for your billing manager to investigate
Structured handoff to staff: all inquiries returned as clear summaries for billing, admin, or care team to action

How it pays back

Keep Complex Admin Off Your Front Desk

Your front desk staff shouldn't spend 10 minutes per call troubleshooting insurance issues. AI captures the inquiry, your billing specialist handles it offline. Front desk stays free for clinical calls and scheduling.

Reduce Member Frustration on Billing Issues

Members know their call is being taken seriously. AI explains what information is being gathered, sets expectation for callback, and ensures nothing falls through the cracks. Member feels heard, not ignored.

Accelerate Prior Authorization Workflow

Member or provider office initiates prior auth request. AI captures procedure, expected date, and clinical indication. Your billing team can start verification and insurance calls immediately, not days later.

Improve Billing Collections and Compliance

All billing and insurance inquiries are logged and traced. Your billing team has a clear queue of member questions and disputes. Documentation improves follow-up, reduces write-offs, and supports compliance.

Insurance inquiries captured

Coverage, deductible, and benefit questions routed to billing staff

Prior auth requests initiated

Procedure and clinical context documented for insurance verification

Billing dispute escalation

Charge questions logged and flagged for billing manager review

Front desk protection

Complex admin calls handled by AI, freeing your team for clinical scheduling

Frequently asked questions

What happens when a member calls with an insurance question?

The AI listens to the question, asks clarifying details (coverage type, procedure date, etc.), and documents the inquiry. The summary is sent to your billing staff, who research the member's plan and call back with the answer.

Can the AI check coverage details directly?

The AI can capture member name, DOB, and policy number, and gather context about the coverage question. Your billing staff uses that information to look up the plan details in your insurance verification system or by calling the carrier.

How are prior authorization requests handled?

Member or provider office requests prior auth for an upcoming procedure. The AI gathers member ID, procedure code, expected date, and clinical indication. That information is logged in your system and flagged for your billing or prior auth team to process.

What if the member disputes a charge?

The AI listens to the dispute, documents the charge in question and the member's concern, and escalates to your billing manager. The manager investigates and follows up with the member.

Do these inquiries integrate with our billing system?

Yes. The AI summary is returned as a structured note for your billing team to review and log in your practice management system or EMR. Your team then creates tasks or entries as needed in your workflow.

How quickly do members get called back on insurance questions?

Timing depends on your team. The inquiry is logged immediately, so your billing staff sees it the next business day at latest. Many practices aim for same-day callback on urgent coverage questions.