Intelligent Authorization

Overview

A single-source solution for every financial clearance automation need.

With approximately half of all denials resulting from front-end revenue cycle issues, optimizing patient access operations has become critical to the patient experience and financial health of any hospital or health system. Our Intelligent Authorization platform enables users to streamline and expedite financial clearance processes through a variety of configurable automation solutions. Whether you require maximal financial clearance automation or simply augmented support for specific specialties, Intelligent Authorization can help improve your overall patient financial experience while growing and retaining the revenue you deserve.

Intelligent Authorization overview

Platform Agnostic Solution Design

Our solution designs are built on understanding the unique needs, challenges, and success criteria of each customer while leveraging a variety of automation platforms provided by AGS Health and our partners.

Enhanced Revenue Growth and Retainment

Prevent denials, reduce aged A/R, improve net revenue reimbursements, and increase clean claim rates across a variety of specialties, including radiology, occupational and physical therapy, surgery, and infusion/diagnostics.

Improved Patient Experience and Transparency

Deliver the speed, accuracy, and transparency your patients expect, including a clear understanding of their benefits, visibility into good faith cost estimates, and prompt access to care through reduced rescheduling rates.

Features

Intelligent Authorization Features and Capabilities 

Financial Clearance and Price Transparency

Automated eligibility and benefits determination

Fast and accurate verification of insurance eligibility and benefits can be achieved through automation during order entries, scheduling, rescheduling, and/or monthly and annual re-verification processes.

Automated prior authorization for improved speed and efficiency

Authorization status is automatically verified via robotic process automation (RPA). Cases that do not require prior authorization are automatically removed from the work queue, while status codes indicating the lack of authorization requirements are appended to the cases before it is transferred back to the EMR.

Reliable patient cost estimation

The fee schedule, along with embedded payor/client-specific rules in the database, is used to generate good faith estimates that are transferred back to the EMR, with additional options for client-specific customization.