Workflow
Prior authorization calls clog pain practice queues and stall procedure schedules. AI captures insurance, diagnosis, procedure type, and current auth status conversationally, then returns a structured summary for staff verification—eliminating transfer loops.
Patients call asking 'Is my procedure approved?' These calls currently interrupt clinical staff. AI captures the full auth context on the first ring and hands staff a structured summary to review, no transfer needed.
Procedures get postponed because insurance info is vague or missing from the chart. AI ensures diagnosis, procedure code, and auth status are documented before the visit, so staff can verify or resubmit quickly.
Patients give different insurance info on the phone than in registration. AI captures it conversationally, returns it as a summary, and staff verify it against the chart and payer portal before confirming the appointment.
Receptionists spend significant time per auth call on hold with payers or on transfers. AI gathers the data upfront; staff review and act on it, freeing phone time for clinical calls.
Insurance captured conversationally
No forms, no patient callbacks for missing data
Auth status documented
Pending, approved, or denied—all captured for staff review
Procedure prep confirmed
Patient confirms fasting, medications, and arrival time on the call
Staff verify and file once
No duplicate entry or phone tag
No. AI captures insurance and auth details conversationally and returns them as a structured summary. Your staff then verify eligibility with the payer using your existing portal or clearinghouse—AI eliminates the data-gathering step.
AI captures that information. When staff review the summary and see the auth is expired, they can resubmit before the visit or contact the patient to reschedule, preventing same-day cancellations.
AI asks the patient about the type of procedure (epidural, facet joint, nerve block, etc.) and whether their insurance mentioned authorization. If it's unclear, AI notes that for staff to verify with the payer.
Appointment details (date, time, patient name, DOB, phone) sync to the EMR. Insurance and prior auth information are returned as a structured summary for your staff to review and file in the chart.
AI notes the denial and escalates immediately to staff. They can contact the patient with next steps, request an appeal, or discuss self-pay options before the appointment is confirmed.
See how MedReception AI handles after-hours calls, scheduling, intake, and patient communication for medical practices like yours.
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