Operations
Prior authorizations for interventional pain procedures can take days. MedReception AI captures insurance carrier, group number, referral source, and prior auth status during patient intake calls—so your staff start the auth process before the patient even arrives.
Your billing team receives a complete insurance summary from the AI call and can submit authorization requests the same day. By the time the patient arrives for their consultation, your authorization is already in progress or approved—no delays.
The AI asks which physician referred the patient and verifies the referral number during intake. If the wrong provider is listed in your system, your staff correct it before the appointment—not after they waste time trying to obtain authorization.
Your clinical staff focus on evaluation and treatment planning, not repeating insurance questions. The AI handles that during the initial call, and your billing team verifies coverage and auth requirements separately.
The AI documents what imaging the patient has already had (MRI from 3 months ago, X-rays from their PCP). Your team sees this and avoids re-ordering unnecessary tests—saving time and reducing costs.
Insurance captured on every call
Carrier, group number, and member ID documented during initial intake
Referral status confirmed
Referral physician and authorization status verified before the appointment
Structured summary for billing
Your billing team receives complete insurance and referral details, ready to submit authorization
Prior imaging documented
Existing MRI, CT, or X-rays logged so unnecessary duplicates are avoided
The AI asks for the patient's name and date of birth. Your staff can look up the insurance information later using your carrier's patient portal or by calling the number on the back of the patient's ID. The AI notes 'Insurance info to be verified' in the summary, and your billing team follows up.
You configure this during setup. For example, you might note 'Blue Cross requires pre-auth for epidural injections' or 'Medicare requires documentation of conservative treatment first.' The AI uses this configuration to flag potential issues during the call and alert your staff.
The AI captures the referring provider's name, practice, and fax number (or patient provides this). Your staff verify the referral using that information and request the referral formally if needed. The AI just collects the data; your team manages the actual referral verification workflow.
The AI does not make clinical judgments about which procedure a patient needs, but it can note common prior-auth triggers based on your rules. For example, if you note 'radiofrequency ablation requires pre-auth,' the AI can flag this in the summary so your billing team is primed to submit authorization once the clinician decides that's the right procedure.
Insurance information is captured during the call and returned in a structured, EMR-pasteable summary for your staff to review and enter into your system directly. This keeps your workflow in your control and ensures insurance data accuracy.
See how MedReception AI handles after-hours calls, scheduling, intake, and patient communication for medical practices like yours.
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