Revenue Cycle

How AI intake identifies insurance eligibility and prior-auth gaps so your staff can address them before the patient arrives

The AI receptionist captures insurance information and asks about prior authorization requirements during the intake call. This data returns as a structured summary for your staff to verify in your billing system—flagging gaps so you can reach out before the appointment.

Insurance details (carrier, member ID, group number) captured on the call and returned in structured format for staff verification
AI asks about known prior-auth diagnoses; staff uses this to check your payer's requirements before the visit
Insurance verification happens before the appointment, not at check-in—reduces billing delays and surprise denials later
Copay and deductible info captured and shared with patient during the call so they arrive prepared
If insurance info is missing or unclear, staff sees the flag and can follow up by phone or patient portal before visit

How it pays back

Reduce billing surprises

Insurance verification and prior-auth checks happen days before the visit, not at the desk. Time to resolve missing auth or coverage issues.

Improve first-visit revenue capture

Copay collected and prior auth confirmed before the patient sits in the chair. Visit can proceed without hold-ups.

Less back-office rework

Intake summary flags insurance gaps. Billing team fixes them during the waiting period, not after the appointment is coded.

Insurance captured on the call

Carrier, member ID, group number, effective date structured for instant staff verification

Prior-auth flags in intake summary

Known diagnoses or procedures flagged so your team can verify payer requirements before visit

Copay confirmed with patient

Patient knows expected cost before arriving; reduces payment surprises at check-in

Frequently asked questions

Does the AI verify insurance coverage during the call?

No. The AI captures insurance details and asks about prior-auth needs. Your billing staff then verifies coverage in your payer portal. The AI's questions help staff know what to check.

What if the patient doesn't have their insurance card?

The AI asks for the carrier name and member ID if available. If the patient doesn't know, your staff sees this flag and can request the card via patient portal or follow-up call.

How does this reduce prior-auth delays?

By capturing prior-auth-triggering diagnoses during intake, your staff knows which procedures need auth *before* the visit. You can submit requests while the patient is in the waiting period rather than discovering the need after the appointment.

Is this data sent to the EMR or kept separate?

Insurance details are captured on the call and returned as a structured intake summary for your staff to review. Your team enters insurance information into your billing system and/or EMR as needed, maintaining full control over the data and its entry.

Bring this to your practice

See how MedReception AI handles after-hours calls, scheduling, intake, and patient communication for medical practices like yours.

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