Workflow
AI collects insurance, authorization codes, and procedure details during patient intake. Returned as a formatted summary for billing staff—no re-entry, no delays.
Insurance eligibility and authorization codes are collected during scheduling. Your billing team has a full day or more to initiate the prior auth request, chase authorizations, and resolve coverage issues before the procedure.
AI captures insurance on the call as a structured summary. Your billing team reviews for accuracy and files it. No re-entry from a handwritten form, no back-and-forth with the patient for confirmation.
The AI collects whether imaging, labs, or consultation notes are required for authorization. Your staff knows exactly what to attach to the auth request before sending it to the payer.
By the time the patient arrives for their procedure, insurance is already verified, authorization is in place or in-flight, and benefits are known. Check-in is faster; surprise denials are rare.
Every insurance detail collected on the call is timestamped and stored. Your practice has a record of when and what was collected—useful for dispute resolution and audits.
Insurance captured on call one
No multi-call back-and-forth to collect prior auth details
Procedure eligibility known immediately
Coverage limits, pre-auth requirements, and specialty referral rules identified before scheduling
Formatted for filing
AI summary is ready for billing to file or submit to insurance without re-entry
Authorization time compressed
Prior auth initiated same day, not the day before service
The AI collects only the member ID, group number, and insurance company name during the call. These details are encrypted and stored per HIPAA standards. Your staff reviews and files the summary; card images or full account numbers are not captured by the AI.
The AI asks for the patient's name and date of birth, then looks up the member ID in your EMR if the patient is established. If new patient, the AI captures what is available and schedules a callback reminder for the patient to provide the full details before arrival.
The AI returns prior auth data as a structured summary for your billing or front desk staff to review and file. This ensures accuracy and compliance oversight before the data enters the permanent chart.
Yes. If your EMR or practice management system has payer-specific rules or bundled prior auth requirements, the AI can reference that logic during the call and alert the patient or staff if pre-auth is needed.
By capturing authorization codes and pre-auth requirements on the call and initiating the request same-day, your practice has time to resolve coverage issues, obtain missing documentation, and get approval before the procedure. Last-minute authorization failures are rare.
See how MedReception AI handles after-hours calls, scheduling, intake, and patient communication for medical practices like yours.
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