How Virtual Assistants Simplify Provider Reimbursement

Inefficient and manual administrative tasks cause poor provider engagement and avoidable delays in care. And while providers and payers work together to improve member care and minimize costs, everyday tasks–insurance verification and reimbursement–remain tedious.

Provider engagement portals reduce this friction by streamlining and automating workflows. But when providers have completed a self-service process and are looking for a quick status check, they frequently default to the payers’ customer contact center. The overuse of contact centers means higher operating costs for payers and increased wait times for providers.

With the use of AI and natural language processing, HIPAA-compliant virtual assistants can simplify payment reconciliation before and after time-of-service. Instead of calling the contact center during business hours and waiting to speak with a provider services rep, or using an online directory or form, providers’ offices can communicate with the virtual assistant from a phone or web chat 24/7.

Costs diminish, clinical outcomes improve, and providers become more engaged. Here’s how:

Prior Authorizations

Authorizations are some of the most inefficient transactions in health care. And while portals have significantly improved the submission process, contact center reps continue to answer an abundance of daily status requests from providers’ offices.

Using the same information the rep would have collected, the virtual assistant can quickly answer whether or not a prior authorization has been processed, and if so, the outcome of that request.

Payers and providers save time and money and align on whether a service, procedure, or medication should proceed.

Reimbursement

After providing care and submitting a claim, providers are ready to be reimbursed. And yet again, they call the contact center because they think they’ll get the fastest response.

But with some basic member information, the virtual assistant can share information with the provider, such as a specific reimbursement amount, or a report of a members’ claim information for the past six months.

Have you considered a virtual assistant?

Hx Virtual Assistants orchestrate the efficient intersection of payer goals and provider needs–improving engagement and clinical outcomes, and effectively reducing contact center costs–in a HIPAA-compliant, cloud-based environment.

Watch our on demand webinar: How Virtual Assistants Simplify Provider Engagement

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