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.
Next step
AI receptionist workflows
Step-by-step workflows for the calls a practice actually gets.
Next step
Automated patient scheduling
Booking, rescheduling and calendar rules the receptionist applies on every call.
Related
Managing Prior Authorization Calls in Interventional Pain Clinics
Prior authorization is a critical part of the interventional pain workflow.
Related
Prior Authorization Tracking for Interventional Pain Procedures
Insurance approval delays block procedure scheduling.
Related
Insurance Pre-Authorization and Prior Auth Calls for Pain Practices
Prior authorization is a pain clinic workflow blocker. Patients book procedures, but pre-auth requests lag.
Next step
AI receptionist for pain management practices
How call handling differs for pain management practices.
Related
Prior Authorization and Medication Calls for Pain Practices
Interventional pain patients call about prior authorization, medication refills, and insurance coverage.
Related
Prior Authorization Routing for Interventional Pain Clinics
Interventional pain practices spend staff hours chasing insurance pre-certifications.
See how MedReception AI handles after-hours calls, scheduling, intake, and patient communication for medical practices like yours.
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