Eligibility & Benefits Verifications Automated

Get patient financial clearance instantly prior to care and preserve claim reimbursement downstream with automated insurance verifications, benefit checks, out-of-pocket payment estimations and hidden insurance discovery.

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PATIENT ACCESS MANAGED BY ONE PLATFORM

Input Patient Details Only Once

Streamline the entire patient access workflow from eligibility verifications, benefit checks, patient out-of-pocket estimations, insurance discovery, prior authorization requests to CDSM consults in one platform, which integrates easily with your EMR.

Entire patient and service details only once to get the answers you need to proceed with patient care.

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POWERED BY AI, RPA, SMART WORKFLOWS & DOMAIN EXPERTISE

Customized Platform Available
For Your Unique Needs

We support healthcare providers of all sizes and specialties from ambulatory practices, physician groups to large hospital systems by offering a software-only option and a software-plus-service option that leverages our resourceful in-house team of agents, specialists and technologists to manage the entire patient access workflow.

We also set up custom platforms armed with robotic process automation (RPA) bots for various use cases to help providers reduce repetitive work performed by their staff so they can focus more on engaging with their patients.

SOFTWARE ONLY

Patient Access

Our platform integrates with your EMR so that your team can perform automated patient access checks instantly during patient registration.

  • Eligibility verifications
  • Expanded benefits view
  • Patient pay estimates
  • Insurance discovery pre-service
  • Patient access analytics
  • Full service support by Infinx team
  • Prior authorization
  • CDSM
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SOFTWARE + OUR SPECIALISTS

Patient Access Plus

Our platform integrates with your EMR with added support from our specialists who manage patient access checks for your organization.

  • Eligibility verifications
  • Expanded benefits view
  • Patient pay estimates
  • Insurance discovery pre-service
  • Patient access analytics
  • Full service support by Infinx team
  • Prior authorization
  • CDSM
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AUTOMATION AS A SERVICE

Automate Patient Access Tasks

Reduce hours spent by staff on mundane tasks in the patient access workflow. RPA bots tackling various use cases custom built for your organization helps.

  • Review and route newly inputted patient cases to appropriate scheduling & patient access workflows
  • Initiate eligibility verifications
  • Initiate benefit checks
  • Calculate patient pay estimates
  • Search portals to uncover
    missing insurance
  • Monitor payer portal for prior authorization request updates
    and post to EMR
  • and much more
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Millions Of Transactions Processed Annually

3.5 M

patient access transactions processed annually

5 M

patients served

$2+ B

revenue collected

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INTEGRATIONS

Compatible With Most EMRs

We offer bi-directional integration with most EHR/EMR/LIS/RIS with API, HL7, FHIR, X12 or EMR developer programs so that your staff can submit and update financial verification requests from your local system Here are some of the systems we integrate or are compatible with.

MedInformatix-Infinx
Infinx - Partner - athenahealth
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reduce eligibility claim denials downstream

Complete Financial Clearance Prior To Care

Verify insurance and confirm benefits to financially clear their patients before service. Our machine learning and artificial intelligence algorithms continues to learn and optimize results with data from your unique cases.

Verify patient’s information with speed

Your registration team will be able to quickly answer and confirm critical patient details instantly in one dashboard prior to care like:

  • Is patient covered by insurance?
  • Is patient covered by additional insurance?
  • Is the information on the patient’s demographic and registration information correct?
  • How many visits are permitted and what benefits are covered under their insurance?
  • What is the patient’s copay, deductible, and out-of-pocket responsibility for the service?

Reduced eligibility denials downstream

Confirming this data during patient registration results in increased reimbursements downstream, because submitted claims will likely not get denied due to insurance verification and benefits issues.

Happy staff and patients

Patient experience, as well as employee satisfaction, also improves when you can avoid sending patients unexpected bills post-care, because patient financial obligations can now be clearly disclosed prior to care.

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PATIENT ACCESS, OUR SOFTWARE-ONLY SOLUTION

Your Staff Powered By Our Technology

Subscribe to Patient Access, our software-only solution where your team uses our software to quickly ensure their patient’s insurance is verified, benefits are present and out-of-pocket expenses are displayed to facilitate payment for the service.

Powered by AI, RPA and extensive integrations

By leveraging artificial intelligence, robotic process automation, extensive payer and clearinghouse integrations, complete patient financial clearance is possible prior to care.

Robust patient eligibility dashboard

Case summary screens clearly displays whether coverage is active or inactive, reasons for ineligibility, plan level eligibility, general benefits like deductibles and out-of-pocket payments, benefit parameters and service level benefits like copayment and coinsurance.

Long hours on the phone or searching portals avoided

Reduce staff time spending hours on the phone or manually navigating payer portals trying to verify incomplete, inaccurate, or expired benefits, as well the risk of write-offs downstream due to eligibility claim denials which ultimately impact reimbursement for service delivered.

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PATIENT ACCESS PLUS, OUR SOFTWARE + our specialists

We Take Care Of Eligibility & Benefit Checks For You

While AI and RPA are making significant strides in optimizing revenue cycle management workflows, there is still a need for experienced team members to manually handle cases that automation cannot handle on its own or if the provider’s staffing challenges are causing backlog in critical revenue cycle tasks.
Clients bring Infinx on as a trusted partner to manage the entire patient access workflow due to our effective and reliable team members who support them. Instead of pushing cases back to our clients, our team takes cases to successful resolution and notify immediately if additional clinical information is needed to complete the task.

Specialists & Agents

Leverage our technology to perform the required patient access tasks.

Customer Success Managers

Ensure our solution works for you at every step with responsive communication and on-demand support.

Technology Solution Experts

Adapt our solution for your unique needs- for rapid data transfer, custom fields, EMR integration and more- without extensive IT infrastructure on your end.

Senior Executives

Leverage their expertise to optimize revenue cycle workflows and outcomes to help your organization grow.

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PATIENT PAY ESTIMATE MODULE

Detailed View Of Patient’s Financial Obligation

Improve cash flow for your organization by educating your patient’s financial responsibility for their requested service by the information presented in our patient pay estimate module.

Out-of-pocket payment estimates calculated by AI

Patient’s benefits are combined with allowed amounts obtained from provider-payer fee schedules to come up with a reliable estimate with details displayed on source of allowed amount and benefits applied.

Recalculate estimate if payments were already submitted

If your patient already submitted payment that was not recorded, your staff has the ability to recalculate the estimate.

Empower staff to collect patient portion prior to care

Arm your staff with data they need so they are able to collect payment, establish payment plans with patients, or even just send estimates to them with your organization’s logo.

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INSURANCE DISCOVERY PRE-SERVICE MODULE

Uncover Hidden Coverage & Reduce Patient Self-Pay Designations

Avoid marking patients as self-pay during when they don’t have their details at time of scheduling by automatically searching for missing coverage details with our insurance discovery module.

Discover missing insurance with AI & analytics

Lean on machine learning, deep data mining, and probabilistic analytics to identify undisclosed insurance coverage due to the following reasons:

  • Missing, invalid primary and secondary insurance
  • Uninsured, charity care and undisclosed by patients
  • DNFB, missing patient demographics, CH rejections

Mitigate risk of non-payment by self-pay accounts

Once insurance is discovered, payer details, patient benefits and out-of-pocket payment estimates are displayed in the same dashboard so your staff can inform their patients, collect when required and reduce claim write-offs downstream.

Prevent making patients unhappy with surprise bills

Help your patients locate insurance benefits that are due to them.

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PRIOR AUTHORIZATION MODULE

Enter Details For Prior Authorization Requests In The Same Dashboard

If you are considering subscribing to our **Patient Access Plus** solution where our software plus our team manages insurance verifications, benefit checks, out-of-pocket co-pay estimates and insurance discovery for your organization, you can now get prior authorization approval results by inputting service details in same window you used for eligibility verification requests.

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ELIGIBILITY ANALYTICS

Leverage Real-Time Data To Gain Actionable Authorization Intelligence

Get real-time insights into your eligibility verifications activity with detailed and robust analytics and reporting.

Real-Time Comprehensive Dashboard

Data gets updated in real-time. Filter reports to see the data that’s important to you.

Insights To Drive Action

Predictive analytics insight into usage metrics to help improve your organization’s eligibility workflow upstream and lower claim denials due to eligibility issues downstream.

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Case studies

How We Help Our Clients

Learn how we work with our clients to solve their insurance verification and benefits check challenges.

Growing Physical Therapy Group Resolves Eligibility And Prior Authorization Bottlenecks Using Automation

With a volume of 50,000 visits a week and at least half of those requiring authorizations, this rapidly growing network realized adding staff alone wasn’t going to be a financially sustainable solution for their patient access needs. Plus, their automated solution for benefits verifications would frequently leave cases incomplete when it couldn’t find the relevant benefits information. Learn how our patient access solution was able to resolve these challenges for them.

Read Case Study >

Full Benefits Verification Coverage For Short Staffed Northwestern Dental Group

Our client is a growing 12 office group with 30 providers in the Pacific Northwest. They approached Infinx for support with benefits and eligibility verification as they were taking on a high number of new patients and finding this process costly in time and labor hours. Read how after our thorough implementation, their staff can now login to the EMR and see that their patients are verified and benefits information updated correctly without them having to double check or worry about it.

Read Case Study >
More Case Studies

Faq

You Asked, We Answered

Curious if our eligibility and benefits solution will meet your needs? Here are the most common questions your peers ask during evaluation.

We are able to verify if the patient has active insurance coverage. After verifying eligibility, we check to confirm the specific service is covered and provide you the benefits at the plan level, including deductibles, stop loss, copays, and co-insurance.
We integrate with most EMR, EHR, and PMS’s through APIs or HL7. Schedule a demo to learn if we integrate with the specific system your organization uses.
We currently support the following specialties – radiology, orthopedics, laboratory and pathology, cardiology, physical therapy, occupational therapy, pain management, and oncology. Please select “Who We Help” in our website’s navigation to learn more about how we support specific specialties with their patient access workflows. Feel free to schedule a demo to learn more from one our solutions experts.
We connect to over 1100+ national and regional payers.
We have the ability to batch eligibility verifications for thousands of patients simultaneously.
Our solution allows you to select a place of service. You can choose from a facility, physician’s office, specialist, or home visit, and we’ll obtain benefits for that setting.
The list of services for which you’ll receive benefits information is listed below:

  • Medical Care
  • Surgical
  • Consultation
  • Diagnostic X-ray
  • Diagnostic Lab
  • MRI/CAT Scan
  • Pathology
  • Emergency Services
  • Urgent Care

Our solution helps you discover any other insurance a patient has and avoid unnecessary bills.

When you are logged in, click on a case and open the summary view. You will see a tab next to “Active Procedure” called “Insurance Discovery”. This tab will show you the new-found coverage along with all the available eligibility and benefits details.

If you are integrating our solution with your EMR, the information is added to the patient’s chart.

Our solution helps you discover any other insurance a patient has and avoid unnecessary bills.

When you are logged in, click on a case and open the summary view. You will see a tab next to “Active Procedure” called “Insurance Discovery”. This tab will show you the new-found coverage along with all the available eligibility and benefits details.

If you are integrating our solution with your EMR, the information is added to the patient’s chart.

We need the patient’s name, date of birth, date of service, payer name, patient subscriber ID, and the provider’s NPI to find coverage.

You can also add service type to obtain service level benefits.

Our solution gives you the ability to input your fee schedule to ensure accurate cost estimates via .xls or .csv files. We can also accommodate multiple facilities with different fee structures.
We calculate a patient’s payment based on their benefits and the allowed amount. Our solution will take that data, determine the patient’s estimated payment, and how we calculated the cost.
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Education

Helpful Resources For Your Team

We create educational materials frequently in the form of virtual office hours, articles, white papers, webinars and podcast episodes which help our clients and peers with common patient access and revenue cycle challenges they face. If you would like us to address a specific topic, feel free to reach out to us.

Are Industry Standard Metrics Right For Your Hospital? With Infinx Senior Product Manager Chuck Rackley Infinx Office Hours Revenue Cycle Optimized Webinar

Article

Patient Access And The Importance Of Insurance Verification

Article

Out-of-Network V. In-Network: How To Set Up A Patient Centered Process

Article

Can Automated Insurance Verification Directly Impact Claims Denials?

White Paper

Guide to Automated Patient Access For Radiology

Reducing Barriers To Prior Authorization And Keeping Up With Payer Guidelines With Infinx Senior Product Manager Aakarsh Sethi Infinx Office Hours Revenue Cycle Optimized Banner

White Paper

Advanced Solutions For Cardiology Patient Access

Webinar

How Insurance Discovery Can Reduce Self-Pay Bad Debt

Explore More Resources

Reviews

Our Clients Grow With Us

We create educational materials frequently in the form of virtual office hours, articles, white papers, webinars and podcast episodes which help our clients and peers with common patient access and revenue cycle challenges they face. If you would like us to address a specific topic, feel free to reach out to us.

Since adopting Infinx’s platform, we’ve seen a 90% decrease in workload on our team, and a 2% denial rate. We’re actually spending a lot more time with patients.

Patient Access Director
Radiology Group in Florida

Are Industry Standard Metrics Right For Your Hospital With Infinx Senior Product Manager Chuck Rackley Infinx Office Hours Revenue Cycle Optimized

As the entire world has been struggling through the COVID 19 staffing issues, Infinx has been an extension of our office, helping us with the most difficult insurance payors to make sure our patients have the services they need. Not only do they go above and beyond, they understand a patient with real issues is attached to that authorization request. The entire team is transparent, communicative, and is a true team…

We count ourselves lucky to have started a ‘partnership’ with the Infinx team and look forward to future solutions as well.

Orthopedic Surgical Authorizations Specialist
Orthopedic Group in Michigan

We’ve had a very positive experience working with you and your team so far… we appreciate their attention to detail and willingness to take feedback!

Senior Director of
Clinical Administration
National Physical Therapy Network

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Eligibility & benefits roi calculator

Calculate Your Savings

Enter in the number of eligibility verifications and benefit checks your team processes each month, the number of staff processing such transactions, and the annual salary of each of your team members.

Check your inbox for results to see how much you can save by incorporating an automated patient access solution at your organization.

Calculate Now

Looking To Automate Eligibility & Benefits Verifications?

Schedule a demo to learn how our AI-powered patient access solutions can help your organization get more patients financially cleared prior to care.

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