Product

Immediate Savings & Increase in Productivity.

Accurate & Verifiable

We provide multiple data points for you to verify that our information is accurate. This includes who we spoke with, a call transcript and recordings.

Highly Customizable

From navigating multiple transfers to follow up questions on niche procedure codes, we have you covered.

Limitless Scale

Whether it’s 5 calls an hour or 500k,
we can handle any volume.

AI Agent

Below are some of the questions that we ask representatives.

For every call we ask the representative their name and reference number.

Benefit Verifications

We ask about network status, plan information, maximums, and coverage of specific procedures. We know that eligibility information is incredibly specific to your specialty, so below are some example questions from current customers.

medical

If this is a Medicare Supplemental plan, does it have network limitations?
Is a referral required for these procedures?
Is this procedure covered via telehealth? Can we use our own HIPAA compliant platform or do we need to use a specific software such as Teledoc?

pharmacy

We can ask about pharmacy benefits, including prior authorization, coverage, and copays.

Is J1745 covered?
Can we buy and bill for this drug?
Does the patient have specialty drug benefits?

behavioral health

We serve in office and telehealth mental health providers.

Is this the correct department for ABA benefits performed in an outpatient facility?
What is the max amount we can charge per office visit?
Is this CPT code covered via telehealth?

prior authorization

We can help with any touch point in the prior auth process that requires a phone call.

Requirements

We can ask whether a specific CPT codes requires prior auth, what forms / documentation is required, and where to send it.

Submission

We can provide the patient history and justification over the phone.

Status

We can ask about whether the PA is found, pending, approved or denied. We can follow up on why how to fix denials.

claim Follow Up

In additional to asking about the status, we can ask the agent to reprocess denied claims based on similar claims that were previously approved.

pending

What date was it last processed?
What is the turnaround time from the last processed date?

paid

If paid by check, what address was it mailed to?
Why was the covered amount adjusted?

denied

Why was the claim denied? What information is required to fix the claim?
We have several similar claims that were approved on prior dates. We think you made a mistake in denying this claim, can you please resubmit?