Workflow
Interventional pain procedures often require prior authorization. Capture insurance details and auth status during the initial call, so billing has time to pursue missing authorizations and your practice avoids cancellations and revenue leakage.
Insurance details and auth status are captured during the booking call. Billing has days, not hours, to pursue missing authorizations and avoid same-day cancellations.
The AI captures member ID, group number, and authorization requirements in a consistent format. Your billing team can verify and file pre-auth without chasing the patient for information.
Out-of-pocket estimates and deductible status are shared during the booking call. Fewer surprise bills and insurance disputes after the procedure.
If the insurance plan requires a specialist referral or primary care pre-clearance, the AI flags it during intake. Your staff can request the referral fax before the appointment.
Insurance captured on every call
Member ID, group number, and pre-auth requirement collected during intake
Pre-auth gaps flagged immediately
Missing or pending authorizations escalated to billing team within hours of booking
Patient financial responsibility communicated
Out-of-pocket cost, deductible, and co-insurance explained during intake call
Insurance data ready for your team
Insurance provider, member ID, and group number returned as structured summary for billing entry
No. The AI captures insurance details (member ID, group, plan) on the call and returns it as a structured summary. Your billing team verifies and enters it into your EMR or billing system. This ensures accuracy and compliance with your data-entry protocols.
Your practice provides a list of procedures and their pre-auth requirements during setup. The AI asks the patient about their insurance plan and checks against that list. For plans the system doesn't recognize, it flags the case for your billing team to verify.
The AI captures the patient's name, phone number, and date of birth and schedules a follow-up call to collect insurance details. Your billing team uses the intervening days to verify pre-auth before the appointment.
The AI can ask the patient about their deductible and co-insurance percentage. A rough estimate is shared during the call. For precise estimates, your billing team can run the insurance verification after the appointment is booked.
Within minutes. The AI's summary is available to your team immediately after the call. Billing reviews it and flags missing authorizations for immediate pursuit—often the same day.
The AI flags the denial in the summary. Your clinical team and billing coordinator work with the patient and insurance to appeal, request a utilization review, or discuss alternatives before the appointment date.
See how MedReception AI handles after-hours calls, scheduling, intake, and patient communication for medical practices like yours.
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