Workflow
Interventional pain practices waste time calling patients back to confirm pre-auth or discover missing authorizations at check-in. MedReception's AI captures pre-auth and procedure details during the first call.
The AI asks 'Do you have a prior authorization from your insurance for this procedure?' during intake. If the caller has the auth number, it's captured. If not, your staff verify with the payer the same day, preventing day-of-appointment surprises.
You configure which procedures require pre-auth for each major payer in your market. The AI asks about authorization status only for procedures that actually need it, avoiding unnecessary questions and speeding up intake for pre-auth-exempt procedures.
The intake summary includes procedure type, pre-auth number (if provided), payer name, and a flag if pre-auth is missing or pending. Your staff can immediately initiate pre-auth requests or contact the payer without re-questioning the patient.
By identifying pre-auth gaps early, you avoid booking procedure appointments that can't proceed. This reduces cancellations, improves OR utilization, and strengthens your staff's credibility with patients.
Pre-auth status captured at intake
Structured summary for staff verification and EMR filing
Procedure type and payer documented
Ready for instant pre-auth request if needed
New patient record created; appointment booked
Pre-auth flag included in structured intake summary
On-call routing for urgent questions
Complex pre-auth issues escalated to clinical staff without gate-keeping
The AI flags this in the intake summary and still completes the appointment booking. Your staff immediately contact the payer to initiate pre-auth using the procedure type, payer name, and procedure code. The patient is confirmed once auth is granted.
No. The AI captures the data needed for pre-auth (procedure, payer, patient insurance ID). Your staff use this structured summary to file the pre-auth request with the payer via your normal process—phone, online portal, or clearinghouse.
Yes. During setup, you specify which procedures require pre-auth for each major payer in your network. The AI will ask about authorization status selectively, reducing unnecessary questions and speeding up intake.
The AI returns pre-auth status, insurance carrier name, authorization number (if available), and a flag indicating if auth is pending. Your staff review and paste this into the EMR's intake or insurance section. The AI does not write directly to insurance fields—this structured summary is reviewed and filed by your team.
Your staff contact the patient to discuss denied pre-auth, explore appeals, or discuss alternative procedures. The AI does not make clinical decisions about appeals—your providers and billing team handle that.
See how MedReception AI handles after-hours calls, scheduling, intake, and patient communication for medical practices like yours.
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