Prior Authorization Approvals Accelerated

Accelerate approvals with 98+% accuracy and 99.5% adherence to turnaround times with Patient Access Plus’ prior authorization module.


Input Details For Eligibility & Prior Authorization In One Platform

Streamline the entire patient access workflow from the same platform you input prior authorization requests. Now you can refer to the same dashboard for eligibility verifications, benefit checks, patient out-of-pocket estimations, insurance discovery, prior authorization requests and CDSM consults.


Customized Platform Available For Your Unique Needs

With Patient Access Plus, you can rely on the same patient and service details inputs to trigger prior authorization workflows that are optimized with AI, automation, intelligent workflow management and support from our in-house team of specialists. 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.


Patient Access

Your team leverages our technology to perform automated patient access activities where possible before scheduling patients.

  • Prior authorization
  • Eligibility verifications
  • Expanded plan & procedure benefits view
  • Patient pay estimates
  • Insurance discovery pre-service
  • Patient access analytics
  • Full service support by Infinx team
  • CDSM


Patient Access Plus

We provide complete coverage where our specialists leverages our technology to manage patient access checks for your organization. CDSM consult module can be added upon request.

  • Prior Authorizations
  • Eligibility verifications
  • Expanded plan & procedure benefits view
  • Patient pay estimates
  • Insurance discovery pre-service
  • Patient access analytics
  • Full service support by Infinx team
  • CDSM


Automate Prior Authorization 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.

  • Initiate prior authorization request
  • Electronically submit request to payer
  • Check payer portal for status updates
  • Post updates to EMR
  • Repeated follow-up with payers
  • Initiate eligibility verification
  • Initiate benefit checks
  • Initiate insurance discovery
  • and other patient access tasks


Shortlist Which Cases Need Authorization Instantly

Leverage AI and extensive integrations for clearinghouses and benefit managers to check if prior authorization approvals are required to care.

Determines if prior authorization is required

Our authorization determination engine automatically determines if a prior authorization is required or not with over 98% accuracy by referring to the payer guidelines and CPT code of the service.

Learn instantly when no authorization is required

If our determination engine determines if authorization is not required, status is updated instantly in your EMcR, and your staff is notified immediately.

Schedule more appointments and save hours

This feature alone has helped our clients schedule more procedures and save their staff hours spent manually reviewing payer guidelines to figure out whether authorization is required.


Automate Initiation, Checks & Updates

Initiate and submit request electronically

If an authorization is required for the service, the case is electronically submitted to the appropriate payer.

If electronic submissions not possible, case is worked manually

Complex requests and submissions to payers who do not accept electronic submissions and require manual intervention can be handled by your team or assigned to our specialists for further processing.

Automated status checks & updates

Automated repeated follow-up with payers and real-time status updates are provided by our RPA bots. Real-time status updates help your staff keep patients informed and procedures get scheduled on time.

Your EMR updated

Once request is approved, the authorization approval package can be automatically sent back to your EMR and displayed in our web portal as well.


We Take Care Of Each Prior Authorization Request For You

While AI and payer automations 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.

We offer a hybrid approach which is particularly beneficial for enterprise healthcare providers, like hospital systems or large outpatient groups, who:

  • are not looking to completely outsource their prior authorization activities and want their teams to continue working on their cases while utilizing our proprietary technology, as well as
  • desire the flexibility to easily assign a subset of their case inventory to Infinx’s specialists to work on if the need arises.

Clients rely on Infinx on as a trusted partner to manage the entire patient access workflow due to our effective and reliable team members who support them.

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 problem solving.

Technology Solution Experts

Get rapid data transfers, 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 at your organization and help you grow.


Create New Cases & Assess Status Quickly

If you are accessing the Patient Access Plus web portal, our simple dashboard enables your staff to easily create new cases, and sort through the cases intuitively with the help of several filters, search and sort options.

  • Product type: Eligibility & Benefits, Prior Authorization or both
  • Progress status: No Authorization Required, In Progress, Action Required, Finalized, and more
  • Facility Name
  • Payer Name
  • Date of Service
  • Ordering Physician
  • Case ID

When you subscribe to our solution, you’ll get access to product demo videos on how to execute each action, a user guide which is updated regularly and a dedicated customer success manager who will help you get the most benefit out of our solution.


Prior Authorization Processing Becomes Easier Over Time

Our machine learning algorithms continues to learn from your unique data and becomes smarter and quicker as more of your prior authorization requests get processed. Here are some of the factors and results we look out for.

  • Determine the need for a prior authorization
  • Identify clinical requirements for a procedure
  • Identify risks of denial or peer review
  • Accurately predicts turnaround time
  • Respond to clinical requirements
  • Identify gaps in documentation
  • Follow up regularly for updates

We continue to innovate our technology and optimize our workflows so your staff don’t have to worry about processing prior authorization requests any longer.


We Help Your Referring Physicians Obtain Authorization Approvals

For some procedures, payers and benefit managers do not accept prior authorizations initiated by rendering providers. If the referring physician does not have capability in place to quickly process authorization requests, this can impact your ability to schedule services efficiently.

Referring physicians become approved users of your subscription

We help remove this bottleneck by making it easy for referring physicians to become approved users on your Patient Access Plus subscription so they can leverage our solution and expertise to quickly obtain prior authorization approvals during the referral process.

Easy sign up process

  • Referring provider signs our digital Business Associate Agreement (BAA) on a custom provider enrollment web page created just for your organization,
  • Referring providers completes the Provider Enrollment form on the web page,
  • Then they can easily submit prior authorizations requests to process.

Schedule more services and reduce denials downstream

By making it easier for physicians to send patients with authorizations already approved, your staff will be able to schedule more services, and claims downstream will have a lesser likelihood of getting denied due to any prior authorization issue.


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.


Millions Of Transactions Processed Annually


prior authorizations processed daily


patient access transactions processed annually


patients served


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 prior authorization request from your local system. Here are some of the systems we integrate or are compatible with.

Infinx - Partner - athenahealth

Case studies

How We Help Our Clients

Learn how we help our clients solve their prior authorization challenges.

Surgery Scheduling Delays Resolved By Automating Prior Authorizations For Michigan Orthopedic Clinic

While receiving a high volume of referrals for their surgical offerings, an orthopedic surgery clinic was experiencing lagging surgical and imaging prior authorizations due to a staffing shortage. They were seeing long turnaround times and had to reschedule surgeries due to a lack of timely authorizations. Reimbursements also slowed down due to the lagging surgery schedule, which was causing cash flow challenges. Learn how our automated prior authorization solution was able to get their schedule and revenue collections back on track.

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

With a volume of 50,000 visits a week and at least a third of those requiring prior authorizations, this rapidly growing network realized adding staff alone wasn’t going to be a financially sustainable solution for their patient access needs. It was a challenge to standardize a prior authorization workflow among the group’s many locations that could be used to efficiently train and onboard staff. They were experiencing high denial rates due to prior authorization errors and had to find a cost-effective way to centralize these in the near future. Learn how our AI-powered patient access solution helped them increase their prior authorization approvals and reduce their staff’s workload by more than 70%.

Our Results

98+ %

prior authorization accuracy rate

24-48 hr

average turnaround times for standard procedures

< 2 %

denial rate

> 50 %

increase in cost efficiency for your organization

> 30 %

boost in your staff’s productivity


Our Clients Grow With Us

As we streamline their organization’s patient access workflows, clients are happy with increased results, as well as improved cash flow due to increase in reimbursements and reduction of claim denials due to eligibility. They usually end up retaining us for other revenue cycle management tasks.

“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

“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


You Asked, We Answered

Curious if our Patient Access Plus solution will meet your prior authorization needs? Here are the most common questions your peers ask during evaluation.

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 all specialties.  Please select “Who We Help” in our website’s navigation to see our list. Feel free to schedule a demo to learn more from one our solutions experts.

We connect to over 1400+ national and regional payers.

Yes. Our solution can automatically determine if an authorization is required based on the CPT code and the payer.

You have the flexibility to upload requests in a batch, or you can create cases one at a time.
If a prior authorization approval cannot be obtained electronically, our specialists step in to coordinate with the payer to obtain approval. You no longer have to worry about authorizations being sent back to your team because the payer does not accept authorization requests electronically.
Yes. You will receive regular alerts and notifications pertaining to your prior authorization requests, including all updates and payer communications, in your EMR. Updates are also accessible in our web portal.
You can submit and update prior authorization requests directly from your organization’s EMR after we connect with your system via an API or HL7-based bi-directional integration.


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 challenges they face. If you would like us to address a specific topic, feel free to reach out to us.


Infinx Patient Access Plus Epic Integration Update: X12 Response Can Now Transfer Documents

Next Generation Solutions To Eligibility And Prior Authorization Challenges


Enhancing Reimbursement Outcomes For Orthopedic Practices

Streamlining Patient Access Amidst Diverse Payer Landscapes With Senior Manager Of Patient Access Jennifer Glockzin Infinx Office Hours Revenue Cycle Optimized


Streamlining Patient Access Amidst Diverse Payer Landscapes

Prior Authorization Transformation At Top Cardiovascular Group


Prior Authorization Transformation At Top Cardiovascular Group

Laboratory Prior Authorization Challenges & Impacts On Reimbursement


Laboratory Prior Authorization Challenges & Impacts On Reimbursement


Infinx Healthcare Named as Representative Vendor in Gartner’s Market Guide for Intelligent Prior Authorization, U.S. Healthcare Organizations


Search Clinical Guidelines For Prior Authorization Online

Access payer policies and clinical guidelines for radiology and orthopedic procedures in seconds with our free AI-powered online search tool.

We help you identify guidelines for prior authorization and medical necessity through a simple query by procedure, payer and diagnosis.

  • Policies and guidelines in our database get updated regularly to stay current
  • Results provided by our AI-powered search algorithm continues to refine as the search volume increases

Search results return only the relevant guideline sections saving you time reviewing and hunting for the information.


Calculate Your Savings

Enter in the number of prior authorization requests your team processes each month, the number of staff processing such requests, 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 AI-powered prior authorization solution at your organization.

Looking To Accelerate Prior Authorization Approvals?

Contact us to learn more about how our AI-powered patient access solution can help your organization get more prior authorization approvals.