Radiology Prior Authorization2019-01-10T07:26:08+00:00
Radiology Prior Authorization

Automate your radiology 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

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.

The Solution –
Automate Your Prior Authorization

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.

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.

Ask to See a Demo of Infinx Patient Access Software for Radiology

Prior Authorization Features:

Real-Time Data
You Need Now

Automate your preauthorization. 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 noauth requirements and preauthorization 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

1

1

Pull Patient Information

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

2

Preauthorization Requirement

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

3

Preauthorization Completed

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.
4

4

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.
1

Pull Patient Information

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

2

Preauthorization Requirement

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

3

Preauthorization Completed

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.

4

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.

Our Results

Preauthorizations
Daily:
4,000+
Satisfied
Customers:
100+
Reduce
Denials by:
50%
Accuracy
Rate:
>99%