Compliance
Prior authorization holds up interventional pain procedures. MedReception captures insurance and prior auth needs during the booking call and returns a structured summary so your team can begin the authorization process immediately.
Insurance information captured on the call means your billing team can submit prior auth immediately, not after a second verification call.
Flagging authorization needs during intake means your staff has time to resolve it before the procedure date.
Caller is informed on the original call if authorization is required and how long it typically takes. No surprises at check-in.
All information is captured and structured; staff does not make additional calls to confirm insurance or authorization needs.
Insurance captured on call
Member ID, group number, and coverage details gathered during initial intake
Prior auth flags identified upfront
Procedures requiring authorization flagged during the booking call, not discovered later
Structured summary for staff
Insurance and auth needs returned as ready-to-action summary, not loose notes
No second verification call
Staff begins prior auth submission immediately; all needed information captured on first call
The system is trained on common prior auth requirements for interventional pain procedures. You can also upload your payer-specific prior auth rules into the system. When a patient books an epidural steroid injection or medial branch block, the AI flags it based on the procedure type and the identified payer.
The AI can ask if they'd like the office to look up their insurance using their date of birth and Social Security number (captured with consent). Alternatively, the patient can provide the information after the call via the patient portal, and staff updates the booking. The appointment is not delayed; authorization begins as soon as insurance details arrive.
No. The system captures insurance and authorization needs and returns them as a structured summary to your staff. Your billing or clinical team reviews the summary and submits the prior auth request through your standard process (payer portal, phone, EDI, or fax). This ensures compliance with your payer contracts and keeps your team in control of the authorization timeline.
Yes. Once your staff updates the authorization status in the system (approved, pending, or denied), the AI can send the patient a proactive notification via SMS or email. This eliminates patient calls asking 'Is my procedure approved?'
Staff is notified immediately. If denial occurs, your team can contact the patient to discuss next steps (appeal, out-of-pocket, alternative procedure). The AI can also send a templated message to the patient explaining the denial and next steps, reducing back-and-forth calls.
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