Prior Authorization Approval
Obtaining prior authorizations is an ongoing struggle for most radiology groups. The prior authorization process can be very time-consuming, often requiring many hours of constant follow-up by your staff, which ultimately takes away from patient care. From the time the order is placed and the actual exam, there are multiple risks for delays and denials. As a provider, you can’t complete the radiology scan unless you receive an approval and sometimes receiving that approval often requires navigating proprietary and nonstandard workflows.
Current solutions over promise on the ability to fully automate the prior authorization workflow and ultimately require human interaction. The prior authorization process is costly, very complex, and creates scheduling nightmares. In addition, payors are continuing to bring more procedures under prior authorization review, and portals and guidelines regularly change. All of these requests frequently take time away from patient care, which directly affects customer satisfaction and your bottom line.
A Scalable Prior Authorization Solution
Infinx Patient Access Software evaluates each case to determine which cases can be automated by AI. Exceptions are managed by our trained and certified team of preauthorization experts.
A Complete Prior Authorization Software for Radiology
Artificial Intelligence to Transform Your Radiology Prior Authorizations
Infinx Patient Access Software for radiology blends automation, integration, cognition, and control to offer you an optimized workflow. It leverages our AI & HI capabilities to provide a robust and seamless solution for managing prior authorization cases. AI optimizes your workflow and automates cases than can be immediately completed, or require no-auth. Cases needing more in-depth attention are forwarded to our global team of specialists who can process your prior authorizations with speed and impeccable accuracy.
Infinx Patient Access Software is built on iBridge, our comprehensive product platform with built-in critical modules that allow you to expand as you grow. The prior authorization module includes seamless HL7 integration to your EHR, and a vast network of clearinghouse integrations, helping you maximize your collections while minimizing denials.
Determining if a case requires a prior authorization shouldn’t be hard. That’s why we’ve created our No Auth Decision Engine to give you immediate insight if a case needs a prior authorization, before spending the time to call a payer. This process can cut as much as 30% of your workload just by reaching a decision ahead of time.
Exception Handling by Proven Experts
Prior authorizations for radiology are complex and inevitably require human intelligence to manage the exceptions. In-house teams often have error rates as high as 35%, which creates a drain on resources and revenue. You can improve your patient access by enhancing and automating your prior authorization process so that you can skip the challenges and see immediate benefits in your workflow, including:
- Authorization appointments processed well within time
- Obtaining a high percentage of prior authorizations
- Low prior authorization denial rates because of complete, accurate, and properly-tracked documentation
Our solutions help you get ahead of the revenue cycle problem by quickly authorizing and confirming every procedure rendered and can be billed with near certainty to its accuracy and propensity to collect. Our experience working with payors nationwide, allows you to receive STAT approvals in as little as 20 minutes and same day appointments within 4 hours, at 100% accuracy and 100% adherence to a 24-hour TAT, allowing you to capture more revenue for your business.
Prior Authorization Features:
You Need Now
Automate your preauthorization. Get the data you need immediately to make good decisions about patient payment and scheduling.
No Auth Required
Get immediate results to determine whether or not a preauth is required for services rendered.
With a real-time recommendations for noauth requirements and preauthorization ETA, you can schedule your patients with certainty.
Cases that cannot be automated are handled by experts who are deeply knowledgeable on payor guidelines and protocols.
Web Portal or
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
Pull Patient InformationThe software pulls this information in via an HL7 message from the client’s system.
Preauthorization RequirementThe software automatically interfaces with the payor system to check if there is a preauthorization requirement.
Preauthorization CompletedThe software automatically sorts the preauthorization by priority of urgency of care, and prepares and files paperwork through the secure EDI with the payor. The Infinx team handles any exceptions.
Sent to Client SystemThe preauthorization package is automatically sent back to the client's internal system, where it can be printed or emailed to the team or patient.
Pull Patient Information
The software pulls this information in via an HL7 message from the client’s system.
The software automatically interfaces with the payor system to check if there is a preauthorization requirement.
The software automatically sorts the preauthorization by priority of urgency of care, and prepares and files paperwork through the secure EDI with the payor. The Infinx team handles any exceptions.
Sent to Client System
The preauthorization package is automatically sent back to the client's internal system, where it can be printed or emailed to the team or patient.