Authorisation Workload
Patients, payers and reviewers all call about the same authorisation. Capture procedure, level, plan and reference number so staff work a case queue.
Almost everything an interventional pain practice does passes through review: the diagnostic block, the repeat block, the ablation, the stimulator trial, sometimes the imaging that justifies them. Each case generates calls from three directions at once, the patient, the payer and the referring office, and all of them arrive on the line the front desk is using to check patients in.
A message that says a patient called about their authorisation costs your team a callback before any work can start. Capturing the procedure, the level and side, the ordering physician and the reference number means whoever picks the case up can go straight to the payer portal rather than reconstructing the question first.
The system reads back only the status your staff have recorded. It does not state that a procedure is approved, denied or covered, does not estimate a decision date, and does not interpret plan language. In a specialty where an approval carries a level, a side and an expiry, a helpful guess on the phone is the expensive kind of mistake.
A review nurse calling for clinical documentation, a vendor confirming receipt of a request, and a patient asking about their injection are three different conversations with three different destinations. Sorting them at the front of the call keeps a time-boxed payer callback out of the general message pad.
Linked to the case, not the call
Repeat status enquiries attach to the open request instead of creating another message
Answered on every line at once
An authorisation caller never queues behind check-in or a scheduling call
HIPAA BAA included
Case, plan and identifier detail encrypted with AES-256 at rest and TLS in transit
No. It handles the call traffic around authorisation: patient status enquiries, payer callbacks, peer-to-peer scheduling requests and referring-office questions, all captured in a structured form. Submission and clinical documentation stay with your team, and captured detail can be delivered into the queue where that work happens.
Only the status your staff recorded, in your wording, and only where your rules permit it. It will not assert approval, denial or coverage on its own, and it will not promise a decision date. If nothing has been recorded, the call is captured and routed rather than answered with a guess.
A denial arriving by phone is captured with the case detail and routed to whoever owns appeals in your practice, flagged under the rule you set. The system does not advise the patient on appeal rights, characterise the denial, or discuss it with the patient beyond what your rules allow.
It applies the list you give it, per payer if you maintain it that way. It does not read or interpret payer policy, and it does not decide medical necessity. Where a caller asks about a procedure that is not on your list, the call is routed rather than answered.
It is captured as a distinct type, with the reviewer's name and direct number, the case at issue, and the window offered, then routed immediately to the destination your rules name. These calls are treated as time-sensitive because the offered window is often measured in hours.
In the destination you choose: an EMR task, an authorisation work queue, a shared inbox, or a structured summary. Writeback is available through API or FHIR for supported systems, and custom integration is available where no direct interface exists.
Authorisation
AI Insurance Pre-Authorization Handling for Pain Practices
The companion page on capturing procedure codes and medical-necessity detail on the way in.
Neurostimulation
Neurostimulation Case Coordination for Pain Clinics
The case type where authorisation, psychological clearance and a facility date all have to line up.
Seasonal demand
Year-End Deductible Surge in Pain and Spine Clinics
The weeks when authorisation turnaround, not clinical capacity, decides what actually gets done.
Pillar guide
AI Receptionist for Pain Management & Spine
How an interventional pain line handles authorisation, refill policy, procedure prep and referral intake end to end.
See how MedReception AI handles after-hours calls, scheduling, intake, and patient communication for medical practices like yours.
