Concierge & DPC
Capture member questions about coverage, prior authorizations, and benefits on the initial call. The AI returns structured summaries so your billing or clinical team can review and respond without chasing the member for details.
Instead of a member calling, leaving a voicemail, and waiting for a callback about coverage or prior auth status, the AI captures the question on the first call and routes it to the right team member with full context.
Your back office receives structured prior auth and benefits questions—not rambling voicemail messages. Insurance policy details, authorization numbers, and the specific question are all there, ready to act on.
When a member asks about prior auth, the AI captures the details so your clinical or billing team can follow up with a full answer. No more members calling back because they didn't get information the first time.
Your providers can see which procedures or referrals commonly trigger prior auth questions. This insight helps you proactively guide members on what to expect.
Prior auth questions captured
Identified and routed on the call, not lost in voicemail
Member insurance details recorded
Carrier, policy number, and authorization details documented
Structured handoff to staff
Billing and clinical teams get actionable summaries, not scattered notes
Routing by question type
Prior auth to clinical, coverage questions to billing, urgent appeals escalated
The AI listens for keywords like 'prior auth,' 'authorization,' 'approved,' 'coverage,' 'insurance,' and 'covered.' It can also ask proactive questions based on the appointment type—e.g., 'Do you need a prior authorization from your insurance for this procedure?'
The AI can't check insurance directly, but it can capture the member's insurance details and the question, then route it to your clinical or billing team. Your staff then verifies status and responds to the member.
The AI can ask about the procedure or referral type and note that a prior authorization may be needed. It routes this to your clinical team, who can proactively reach out to the member with next steps before the appointment.
Benefits and coverage questions go to your billing or insurance team. Prior auth requests for specific procedures go to the relevant clinical team. Urgent appeals or denials are escalated immediately.
Yes. Because the member's question and insurance details are captured on the first call, your team can respond faster. Instead of getting a voicemail with fragmented information, they have a complete picture and can provide an answer quickly.
Workflow
Call routing and triage
How calls are routed to the right team based on question type and urgency
Practice Model
AI receptionist for concierge and dpc practices
Workflows and capabilities for concierge and membership-based care
Workflow
Patient intake
How intake data—including insurance and prior auth questions—is captured and structured
See how MedReception AI handles after-hours calls, scheduling, intake, and patient communication for medical practices like yours.
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