Prior Authorization2019-07-15T11:23:34+00:00

Complete Prior Authorization Coverage

Get faster approvals with AI-driven prior authorization technology with exception handling by specialists.

prior authorization
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The Challenge

Lack-of-automation-Infinx

Prior Authorization Approval

Doctors and staff spend way too much time on getting a prior authorization approved. More than 9 in 10 physicians (91%) say that prior authorization programs have a negative impact on patient clinical outcomes. Every week a medical practice completes an average of 31 prior authorization requirements per physician, which takes the equivalent of nearly two business days (14.9 hours). This creates scheduling nightmares and takes time away from patient care.

How Our Prior Authorization Software Can Help

Intelligent-Patient-Access-Infinx

Artificial Intelligence to
Transform Your Prior Authorization Process

Our Prior Authorization Software blends automation, AI, analytics, and human domain expertise to offer a comprehensive solution to the prior authorization process. Our software leverages AI and automation, with exception handling by our certified prior authorization specialists to preserve and increase revenue by streamlining your prior authorization workflow.

Improve your patient scheduling experience with the Authorization Determination Engine, applying machine learning to provide a real-time decision whether a prior authorization is required or not.

Requests requiring a prior authorization are submitted electronically to the appropriate payer, using a unified interface. Complex requests and exceptions are handled by a team of trained specialists to ensure complete coverage of your prior authorization claim.

Status notifications are communicated real-time through automated follow-up.

Prior Authorization Software Features:

Provider
Integration

Submit and update your prior authorization requests directly from your local EHR/EMR using either an API or HL7 based bi-directional integration.

Authorization
Determination Engine

Determine if your request requires a prior authorization using the Authorization Determination Engine, built using machine learning.

Unified
Workflow Experience

Perform all prior authorization related functions on a unified web portal, built to offer you an intuitive and seamless experience.

Automated
Authorization Follow-up

Keep up with the status of an initiated prior authorization claim using automated authorization follow-up.

Analytics
and Reporting

Obtain full transparency into your prior authorization process using detailed and robust analytics and reporting.

Alerts
and Notifications

Receive constant alerts and notifications pertaining your prior authorization claim, which includes all updates and payer communications

How We Do It

1

1

Is Authorization Required?

Our software determines if a prior authorization is required or not. If an authorization is not required, you are notified immediately so you can schedule the procedure.
2

2

Initiate and Submit Request

If authorization is required for the procedure, the claim is electronically submitted to the payer. Complex claims and manual submissions are handled by our certified prior authorization specialists.
3

3

Automated Status Checks

Automated follow-up with payers and real-time status updates provided to help your staff schedule procedures on time.
4

4

System Updated

Once prior authorization is obtained, the authorization approval package is automatically sent back to your system.
1

Is Authorization Required?

Our software determines if a prior authorization is required or not. If an authorization is not required, you are notified immediately so you can schedule the procedure.

2

Initiate and Submit Request

If authorization is required for the procedure, the claim is electronically submitted to the payer. Complex claims and manual submissions are handled by our certified prior authorization specialists.

3

Automated Status Checks

Automated follow-up with payers and real-time status updates provided to help your staff schedule procedures on time.

4

System Updated

Once prior authorization is obtained, the authorization approval package is automatically sent back to your system.