Workflow
AI captures insurance information, prior authorization requirements, and coverage questions during patient calls. Details are returned as a structured summary for your staff to review and submit to insurers.
Your staff doesn't have to call the patient back to confirm insurance or authorization status. The AI captures this during the initial contact—patient can be told at that moment what to expect or what documentation is needed.
The AI asks whether the patient's current insurance requires a prior authorization for their migraine medication. If yes, medication name and indication are captured so your staff can submit the form immediately without delay.
Your medical assistant or insurance specialist receives a complete summary—patient name, insurance carrier, member ID, medication, indication, quantity, duration. They can build the prior auth form or make the insurance call without asking the patient for clarification.
When prior auth is required, your quick processing means the patient's medication is approved and ready faster. No gaps in migraine prevention or acute treatment.
Insurance captured on first call
Member ID, group number, and coverage details documented without follow-up
Prior auth requirements identified
Medication name, indication, and duration flagged for insurance submission
Structured summary for staff
Insurance and authorization details formatted and ready for processing
No patient callback needed
Staff has complete information to submit prior auth or confirm coverage
The AI asks about insurance on new patient calls, appointment booking calls for established patients without documented insurance, and calls related to medication refills or prior authorization. For routine appointment confirmations with existing patients whose insurance is on file, the AI can skip this unless the patient mentions a coverage question.
The AI is configured with common migraine medications and their typical authorization requirements. Triptans, CGRP antagonists (erenumab, fremanezumab, eptinezumab), and some preventive agents frequently require prior auth. If the patient mentions a medication on that list, the AI flags it and asks about authorization status.
During the call, the AI captures current insurance details. Your staff updates the patient's record. If the patient's insurance changes between calls, the AI will ask for updated information at the next call.
No. The AI captures the necessary information and returns it to your staff as a structured summary. Your medical assistant, nurse, or insurance specialist reviews the details and submits the prior auth form to the insurance company through the standard channels (fax, online portal, or automated clearinghouse).
The AI still captures the insurance and medication details. Your staff can note that authorization is not required and proceed with the prescription. Having complete insurance information on file prevents delays later if the patient switches plans or the medication changes.
That depends on your staff workflow and the insurance company's response time. MedReception provides all the information your team needs to submit the form immediately—the AI call typically takes 2-3 minutes, and your staff can begin processing within minutes of the call ending.
Related
Patient intake
Structured intake captures insurance and patient demographics during initial patient contact.
Related
EMR and EHR integrations
Patient demographics and insurance information are returned as a structured summary for your staff to review and file in your EMR.
Related
HIPAA and compliance
Insurance information is captured securely and stored in compliance with HIPAA.
See how MedReception AI handles after-hours calls, scheduling, intake, and patient communication for medical practices like yours.
Want the numbers first? See plans and pricing
