Interventional Pain

AI checks insurance coverage and prior auth flags during consultation calls—no surprise denials on procedure day

Pain patients often discover insurance barriers after booking. Our AI verifies coverage and flags prior authorization requirements during the initial consultation call, so your team can address issues before the patient arrives for the procedure.

Checks insurance eligibility and coverage status in real time during the consultation call
Identifies prior authorization requirements and communicates them to the patient before confirming the appointment
Flags known denials, referral requirements, or specialty restrictions for your billing team to address proactively
Captures insurance details and reason for procedures so your billing staff can pre-submit prior auth if needed
Logs eligibility status and any barriers as a structured summary for your team to review and file

How it pays back

No procedural cancellations due to insurance surprises

Coverage barriers are surfaced during the consultation, not at check-in. Your team has time to resolve auth issues or discuss cost-sharing before the patient's procedure date.

Prior auth requests are submitted early

The AI identifies which procedures need pre-approval. Your staff submits auth requests immediately, giving insurers time to process before the scheduled date.

Patients understand their out-of-pocket costs upfront

Insurance eligibility is clear during the call. Patients can decide on the procedure and ask questions about cost-sharing before committing to a date.

Your billing team is not playing catch-up

Insurance verification is already done. Your staff focuses on auth follow-up and payment processing, not chasing missing eligibility data on procedure day.

Appointment slot is protected

Because eligibility is confirmed during the consultation, you can confidently hold the procedure slot. Fewer cancellations and rebooks.

Insurance eligibility checked on the consultation call

Coverage status and prior auth flags identified before patient is scheduled

Prior auth barriers flagged early

Procedures requiring pre-approval are identified so your team can submit auth proactively

Patient cost-sharing communicated upfront

Out-of-pocket estimates shared during the call so patients can plan

Eligibility and auth status logged for your team

Your team has full visibility of insurance barriers and next steps

Frequently asked questions

How does the AI access insurance eligibility information?

The AI queries your EMR or integrated eligibility service in real time during the consultation call. When the patient provides their insurance info, the AI checks coverage for the specific procedure (epidural steroid injection, facet block, RFA, etc.) and returns the eligibility status immediately.

What if the insurance information on file is outdated or incorrect?

The AI can ask the patient for current insurance details during the call, verify the information, and capture it. Your team reviews and updates it in your EMR. This real-time correction prevents eligibility lookup errors.

Can the AI communicate prior auth requirements to the patient during the call?

Yes. If the AI finds that the procedure requires prior authorization, it communicates this to the patient, explains what it means, and confirms that your clinical team will submit the request. The patient is never surprised by auth delays.

What if the insurance denies or requires a specific referral?

The AI flags known denial patterns and referral requirements during the call. Your billing or clinical staff can then discuss options with the patient or contact the referring provider to ensure the referral is in the system before the procedure.

Does the AI submit prior authorization requests on its own?

No. The AI identifies prior auth needs and logs them in your chart. Your clinical or billing staff submits the auth request to the insurance carrier. This separation ensures a clinician is involved in the auth decision.