Essential for modernizing administrative processes, increasing operational efficiency, and improving the experience of all healthcare stakeholders.
The Administrative Agent (Authorization and Referral Management) automates the entire process of requesting, processing, and approving referrals and authorizations for exams and procedures with health insurers. This agent eliminates manual steps, speeds up response times, and reduces errors, providing greater agility and efficiency for hospitals, clinics, and insurers. It also facilitates communication among all parties involved, promoting a smoother experience for patients and administrative teams.
1. Faster response times: Automates critical steps, speeding up the authorization process and preventing delays in care.
2. Reduced rejections and rework: Identifies missing information before submission, ensuring higher approval rates on the first attempt.
3. Operational efficiency: Frees administrative teams to focus on more strategic tasks.
4. Greater transparency: Real-time updates allow teams and patients to track the status of requests.
5. Improved patient experience: Reduces waiting time for approvals and enhances overall satisfaction with the service.
Saúde Ativa Clinic, specialized in imaging exams:
The agent automatically receives referral requests generated by the clinic's scheduling system.
Fills out authorization forms according to the specific rules of partner insurers and submits them in real-time.
When an MRI is requested, the agent identifies missing clinical information in the request and notifies the medical team to complete the data.
Authorization and Referral Management
Automation of the request, processing, and approval flow for referrals and authorizations for exams and procedures.
Discover how PsycoAI can help your company transform the customer experience with our conversational AI agents.
Learn more