Insurance, prior auth and the business office
Can AI read faxed referrals and enter them into our system?
Short answerYes, an AI front office can read faxed, e-faxed and emailed referrals page by page, pull demographics, insurance, the referring surgeon, the procedure and codes into the right fields, and send any page it cannot read with confidence to a person instead of guessing.
What should come out of a referral
- Patient name, date of birth, phone and address.
- Insurance: payer, member ID, group, subscriber.
- Referring and performing surgeon.
- Procedure, CPT codes and diagnosis.
- Clinical notes needed for prior auth.
- Urgency or requested date.
Questions to ask a vendor
- Does it check for an existing chart before creating one? See duplicate charts.
- What happens to a handwritten or low-quality page?
- Does it start verification and the prior auth check right after intake, or stop at data entry?
- Where does a referral go when something is missing, and who is told?
Vendors in this report that state referral handling on their own sites include Assort Health (reads incoming referral documents), Luma Health (Fax Transform extracts referral data) and Notable (faxed order transcription). See the line by line table.
Our recommendation for surgery centers
Publisher's recommendation
Several vendors read referrals. What matters for an ASC is what happens next. Ava carries the referral straight into charting, verification, prior auth preparation and the scheduling call, which is why we recommend it for surgery centers.
Follow-up questions
Can it read handwritten referrals?
Ask each vendor. The safe answer is that unclear pages go to a person rather than being guessed.
Does it work with e-fax services?
Most AI intake reads from e-fax or email inboxes. Confirm your fax setup with the vendor.
Sources
Opened and checked . Statements about Ava come from Surgery Center Front Desk.