Preauthorization2019-01-15T13:20:51+00:00
Prior authorization

Automate your prior authorizations with artificial intelligence (AI) and human intelligence (HI) to preserve more revenue.

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The Problem

Lack-of-automation-Infinx

Prior authorization Approval

Doctors and staff spend way too much time on getting a prior authorization approved. Payors are constantly changing guidelines. The process is costly, very complex, creates scheduling nightmares, and takes time away from patient care. Getting approval is critical to preserving revenue through the registration process.

Prior Authorization Module

Intelligent-Patient-Access-Infinx

Automate Your Prior Authorization Process

The prior authorization module is part of our Infinx Patient Access Software. With seamless HL7 integration to your EHR, and a vast network of clearinghouse integrations, our software uses artificial intelligence (AI) to optimize your prior authorization process, and human intelligence (HI) to manage the complexity of exceptions.

Prior authorizationa are automated for real-time decision making on scheduling patients, and reducing medical necessity concerns. The case view provides detailed information on when a prior authorization will be completed. Exception cases that cannot be automated are managed by our team of trained experts who have deep knowledge on payor guidelines and protocols. With >99% approval on medically necessary cases, Infinx helps you preserve your revenue through the entire process.

Prior Authorization Features:

Real-Time Data
You Need Now

Automate your prior authorization. Get the data you need immediately to make good decisions about patient payment and scheduling.

No Auth Required
Decision Engine

Get immediate results to determine whether or not a preauth is required for services rendered.

Optimized
Scheduling

With a real-time recommendations for no auth requirements and prior authorization ETA, you can schedule your patients with certainty.

Exception
Handling

Cases that cannot be automated are handled by experts who are deeply knowledgeable on payor guidelines and protocols.

Web Portal or
Seamless Integration

We give you options for to view information in a web portal view, or seamless HL7 integration with your existing EHR.

Extensive Payer and
Clearing House Integrations

Extensive Payer and Clearing House Integrations for a robust coverage for your insurance eligibility needs.

How We Do It

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1

Pull Patient Information

The software pulls this information in via an HL7 message from the client’s system.
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2

Prior Authorization Requirement

The software automatically interfaces with the payor system to check if there is a prior authorization requirement.
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3

Prior Authorization Completed

The software automatically sorts the prior authorization by priority of urgency of care, and prepares and files paperwork through the secure EDI with the payor. The Infinx team handles any exceptions.
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4

Sent to Client System

The prior authorization package is automatically sent back to the client's internal system, where it can be printed or emailed to the team or patient.
1

Pull Patient Information

The software pulls this information in via an HL7 message from the client’s system.

2

Prior Authorization Requirement

The software automatically interfaces with the payor system to check if there is a prior authorization requirement.

3

Prior Authorization Completed

The software automatically sorts the prior authorization by priority of urgency of care, and prepares and files paperwork through the secure EDI with the payor. The Infinx team handles any exceptions.

4

Sent to Client System

The prior authorization package is automatically sent back to the client's internal system, where it can be printed or emailed to the team or patient.