AUTOMATION AGENT
Automate TRICARE referral authorization follow-ups with ease
While payers typically require primary care physicians (or other referring providers) to initiate patient referral authorization requests, rendering providers often need to follow-up with payers to ensure the request has been approved. As a result, specialty provider staff must continuously login to payer portals to check the approval status of patient referrals and ensure timely patient scheduling.
Although the TRICARE portal is designed to coordinate coverage and provide essential status updates, staff still need to leave their EMR to verify documentation or reconfirm decisions. In practice, this means repeatedly logging into the portal—a process that diverts time from higher-value tasks and adds administrative strain, ultimately delaying access to specialty care.
At Infinx, we streamline TRICARE follow-up with an automation agent that delivers status checks in minutes and maintains 99% accuracy. Your staff sees direct updates in your EMR, ensuring a seamless flow of information and faster approvals.
Available as a standalone automation agent in our Revenue Cycle Agent Platform, this technology integrates smoothly into your existing workflows.
HOW WE ENHANCE YOUR TRICARE REFERRAL AUTH WORKFLOW
Referral approvals sent directly to your EMR
Eliminate manual tracking and ensure referral authorization updates flow directly into your patient information system (e.g., RIS, LIS, EMR)—without staff intervention.
- Our automation agent logs into TRICARE, retrieves the latest referral auth updates, and syncs them with your EHR, so staff no longer have to check for updates manually.
- Automated EMR updates ensure approved, denied, or pending statuses are reflected automatically, keeping staff informed.
- Scalable automation handles high volumes of authorizations, reducing administrative workload.
With real-time alerts, proactive tracking, and automatic documentation updates, specialty providers can stay ahead of referral approval status changes and reduce delays in patient care.
Our other automation agents also help fill in these gaps by integrating with other clearinghouses and benefit managers like Availity and UHC to ensure complete referral auth follow-up coverage.
HOW IT WORKS
A fully automated solution for tracking referral authorization status
Once a referral authorization follow-up request is submitted our automation agent takes over, ensuring timely updates and reducing manual effort.
A job is created in the Revenue Cycle Agent platform
Our platform accepts referral authorization follow-up requests in several ways. With integration, it automatically pulls referral details from your system. Without integration, you can run referral authorization checks on multiple cases at once by uploading a batch file, or manually enter a referral's member ID and DOB for a single case.
Referral authorization status retrieval
The automation agent retrieves the latest status (Approved, Denied, or Pending) and approval or denial details directly from TRICARE.
System updated with status
Your EMR is automatically updated with the latest authorization status, details, and attachment letters, ensuring real-time visibility for your staff.
Details include referring and rendering provider details, service and procedure type, number of authorized visits, effective and expiration dates, and the authorization number.
Ongoing follow-ups
For unresolved cases, the automation agent re-engages with TRICARE at set intervals (e.g., every 6 hours) until a final decision is reached.
By automating the follow-up process, we help providers to leverage TRICARE more effectively, ensuring that every referral authorization request is tracked, updated, and managed with ease.
Ready to automate referral authorization status checks with TRICARE?
With our TRICARE referral authorization follow-up automation agent, you can eliminate manual follow-ups for patient referral approvals. Get updates sent directly to your EMR, reducing administrative workload and ensuring accurate information. Schedule a demo to learn more.