AGS AI PLATFORM
Intelligent Authorization
Overview
A single-source solution for every financial clearance automation need.
With approximately half of all denials resulting from front-end revenue cycle issues, optimizing patient access operations has become critical to the patient experience and financial health of any hospital or health system. Our Intelligent Authorization platform enables users to streamline and expedite financial clearance processes through a variety of configurable automation solutions. Whether you require maximal financial clearance automation or simply augmented support for specific specialties, Intelligent Authorization can help improve your overall patient financial experience while growing and retaining the revenue you deserve.
Platform Agnostic Solution Design
Our solution designs are built on understanding the unique needs, challenges, and success criteria of each customer while leveraging a variety of automation platforms provided by AGS Health and our partners.
Enhanced Revenue Growth and Retainment
Prevent denials, reduce aged A/R, improve net revenue reimbursements, and increase clean claim rates across a variety of specialties, including radiology, occupational and physical therapy, surgery, and infusion/diagnostics.
Improved Patient Experience and Transparency
Deliver the speed, accuracy, and transparency your patients expect, including a clear understanding of their benefits, visibility into good faith cost estimates, and prompt access to care through reduced rescheduling rates.
Features
Intelligent Authorization Features and Capabilities
Financial Clearance and Price Transparency
Automated eligibility and benefits determination
Fast and accurate verification of insurance eligibility and benefits can be achieved through automation during order entries, scheduling, rescheduling, and/or monthly and annual re-verification processes.
Automated prior authorization for improved speed and efficiency
Authorization status is automatically verified via robotic process automation (RPA). Cases that do not require prior authorization are automatically removed from the work queue, while status codes indicating the lack of authorization requirements are appended to the cases before it is transferred back to the EMR.
Reliable patient cost estimation
The fee schedule, along with embedded payor/client-specific rules in the database, is used to generate good faith estimates that are transferred back to the EMR, with additional options for client-specific customization.
Smart Workflows
Fast, flexible data transfer
Data can be transferred from your EMR through HL7 in near real-time or as a flat file through SFTP on a pre-determined frequency for add-on appointments.
Simplified task management and automated case assignment
Our proprietary rules engine automatically validates authorization requirements and allocates claims to the relevant work queues, enabling them to be organized and prioritized for manual review based on service date and time.
Enhanced documentation management and accessibility
The platform generates and stores outcome-based documentation, such as authorization approvals and estimates, which can be conveniently accessed and transferred back to the EMR system. Data fields transferred to the EMR after receiving authorization approval include the authorization number, approval span dates, any other pertinent data, and a screen of the approval linked to the patient account.
Insightful and Actionable Analytics
Self-service reports for on-demand status monitoring
Instantly generate self-service reports to help track the status of current cases, inform strategic planning, and assist with the prioritization of tasks.
Customizable dashboards for simplified reporting
See a comprehensive overview of pertinent information for each user, as well as insights on prior authorization submission trends, authorization status approval, eligibility verification, and top error categories.
Flexible data management
Parse your data quickly with simple filtering capabilities that enable users to view insights across different dimensions, create action plans, and make decisions faster.
BENEFITS
Experience the impact of Intelligent Authorization.
Compared to manual processes, Intelligent Authorization can significantly enhance productivity and reduce the time required for financial clearance processes.
Improvement in authorization determination time
Less time on authorization initiation
Shorter authorization follow-up times
Faster price estimation
Resources
Dig deeper into Intelligent Authorization.
Integrations
Seamlessly integrate your legacy systems with ease.
More Technology
Autonomous Coding
Achieve true coding autonomy through advanced artificial intelligence and award-winning services in one seamless, effortless solution.
Computer-Assisted Coding
Transform your manual coding workflow into an AI-coder collaboration that positively impacts your coding quality, CMI and DNFC.
Computer-Assisted Professional Coding
Streamline your professional coding process with improved charge capture while reducing denials and improving quality and compliance.
Computer-Assisted CDI
Automate the review of clinical documentation and queries without using a single spreadsheet.
Revenue Cycle Automation Analytics
Manage and forecast your automated revenue cycle management workflows for peak performance.
Analytics & Reporting
See your data like never before without the constraints of your EHR reporting capabilities.
Intelligent RCM Engine
AGS Health’s Intelligent RCM Engine is a proprietary suite of workflow orchestration tools that integrate artificial intelligence, machine learning, analytics, and digital workers to optimize work allocation, automate tasks, and support informed decision-making to enhance our patient financial services.
Clinical NLP APIs
Natural Language Processing APIs that enable you to extract meaningful clinical entities from bundles of unstructured data, seamlessly.
connect with us
Join our early access program today.
When you create a high-performance revenue cycle, you’re finally free to invest your full resources into what matters most: the care of your patients.
