How Augmented Intelligence Solves the Prior Authorization Revenue Bottleneck for Orthopedic Practices

With an estimated 182 million prior authorization transactions processed per year, according to MGMA, it is easy to see where issues are bound to arise related to the sheer volume. It’s hard to believe that prior authorizations are the least automated business function for orthopedic groups.

We hear a lot these days about artificial intelligence, but what does that mean for solving our most frustrating problems like reducing manual, time-consuming, repetitive tasks from the prior authorization equation?

However, today there are tech-enabled service solutions available that optimize the prior authorization workflow to ensure that patients get the timely care they deserve without negatively affecting your bottom line. An augmented intelligent prior authorization solution that combines automation and AI-driven technology, with experienced certified prior authorization specialists, accelerates your prior authorization approvals and decrease denials – ultimately maximizing your revenue and improving overall patient satisfaction.

By taking advantage of advanced technology coupled with targeted human intelligence, we are entering a new proactive revenue generation collection phase. Many general-purpose AI solutions are nothing more than spot analytics solutions branded as AI, which require significant investments with uncertain results. Someday, AI may evolve to the point of completely automating the prior authorization process – but, until then, orthopedic practices should look to incorporate an augmented intelligent solution for better decision making and outcomes.