Workflow 05 · Insurance and authorizations

Insurance,settled before the visit.

Once you’re onboard, every insured visit is checked with the payer when it’s booked and again two days out, and every signed order is checked for prior auth. When it needs one, the packet is built from the chart, your coordinator approves it, and it’s chased until there’s a decision. Patients know what they’ll owe before they arrive.

Works with 20+ EHRs: athenahealth · ModMed · eClinicalWorks · AdvancedMD · Nextech · Healthie · and more
bookings and orders · this morningexample
New patientPPO plan · card readactive · $40 copay
MRI left kneeorder signedauth filed
Follow-upHMO planreferral requested
Physical therapyMedicareno auth needed
Knee injectionestimate above thresholdwith billing lead
Lumbar injectiondeniedappeal drafted
one new patientsettled before the visit
Booked · card link sent
Payer says active · copay read
Re-checked 48 hours out · unchanged
your numbers, not ours

Every insured visit is a check someone makes. Every auth is an hour someone types.

Put in your clinic’s own figures. We’d rather show you your math than quote someone else’s study.

40staff hours a week checking coverage
15staff hours a week on authorizations
2,729staff hours a year, both together

Coverage hours = insured visits × minutes per check ÷ 60. Auth hours = requests × minutes per auth ÷ 60. A year is 50 working weeks.

insurance and authorizations · booking to decision

From the booking to the payer’s answer. Each one finished.

Scroll to follow it ↓

01Mon 10:14

A new patient books a dermatology visit by phone and says she has insurance. The check starts at the booking.

todayThe card is copied at the window on visit day.
02Mon 10:19

She gets a secure link to photograph her card. Intuo reads it, asks the payer, and reads back what the payer says: active, plan type, specialist copay, deductible left.

todayA payer website, one patient at a time.
03until the visit

Coverage and the card image are written to the chart, never over what your desk entered. She gets her estimate by secure link. On Wednesday it’s checked again, 48 hours out.

todayChecked once, if at all.
04closed

Closed at check-in. Receipt on the appointment: the payer’s answer, the plan, the copay and the chart entry.

todayA sticky note on the chart.
who signs off

Signs: nobody per visit. Your billing lead approves which visits are checked and the wording of every patient message once, at setup.

01Mon 10:1402Mon 10:1903until the visit04closed
who's on it

The coordinators who run it. The person who signs off.

Insurance Verification SpecialistEligibility checks, before the visit.Prior Authorization SpecialistApprovals filed, not forgotten.Patient Financial CounselorCost estimates, signed before the visit.
Your authorization coordinatorApproves every auth packet and referral request before it reaches a payer or another office. Your billing lead approves high estimates; your provider signs appeals.
inside the EHR you already use

Coverage and auths land in your chart, on the order they belong to.

EHRReads coverageWrites coverage and the cardSees the orderFiles the auth
athenahealthPatient insurance and benefit detailsInsurance record + card imageNew and changed ordersAn authorization record on the order
ModMedCoverages on the chartCard image on the chartService requestsThe approval letter on the chart
eClinicalWorksCoverages on the chartCoverage + card as an ID documentFrom the order or the order faxA task with the auth number, plus the letter
AdvancedMDPatient insuranceInsurance + card as a patient documentFrom the visit or the order faxA patient note with the auth number, plus the letter
ElationPatient policiesPolicy + card as a documentFrom the order fax or your teamThe approval letter on the chart
NextechRead from the patient’s cardCard image on the chartFrom the order fax or your teamThe approval letter on the chart

Works with 20+ EHRs, including these and more. The eligibility check goes straight to the payer, so it works the same whichever EHR you use.

your first 14 days

What we build, test and turn on once you’re onboard.

We work in your office beside your team for up to four weeks. Nothing runs on its own until it has worked on your real data, in front of your people.

  1. Days 1 to 3Connect and load your rulesYour EHR, the visits you check, the plans you accept, your cost threshold, and your top ten auth codes with each payer’s rules, all on one screen your owner approves.
  2. Days 4 to 7Check beside your teamEvery insured booking is checked and every signed order gets an auth call while your team works as usual. You compare ours with theirs. Nothing is written yet.
  3. Days 8 to 11Coverage at booking, liveThe card link, the check at booking, the 48-hour re-check and problems on your desk’s list two days ahead. Your desk approves each chart entry at first.
  4. Days 12 to 14Auth packets for your top ten codesPackets built from the chart, approved by your coordinator, filed the payer’s way and tracked to a decision, with a receipt on every order.
you stay in control

Intuo does the checking, gathering and chasing. Your people make the calls.

Covered means the payer said so.Intuo calls a patient covered or in network only when the payer’s own eligibility answer says so. Anything less goes to your desk.
Nothing reaches a payer without a yes.Your coordinator approves every auth packet and referral request. Your provider or coordinator signs every appeal.
No invented clinical facts.Every line in a packet points to the chart. Anything missing is asked for, not filled in. Desk-entered coverage is never overwritten.
Money waits for a person.Estimates above your threshold go to your billing lead first. Nothing is charged, and no plan details travel in a text.
Approvals, switches and receipts: Visibility and control
questions

What clinics ask first.

How does Intuo know a patient is covered?

It asks the payer. Intuo checks eligibility directly with the payer at booking and again 48 hours before the visit, and it only calls a patient covered or in network when the payer’s answer says so. When the answer is unclear, your desk sees it two days ahead with what was tried.

What happens when coverage can’t be confirmed?

Intuo retries with the usual fixes, asks the patient for a photo of their current card, and can search for coverage when they don’t know their plan. If it still isn’t settled two days out, your front desk lead decides: keep the visit, switch to self-pay, or reschedule. Nothing is cancelled on its own.

Will patients get cost estimates by text?

They get a secure link, never plan details in the text itself. Plain copays go out on their own under the wording your billing lead approved. Anything above your threshold waits for your billing lead.

How does Intuo know an order needs auth?

It checks the order’s code and place of service against the patient’s coverage and that payer’s rules. When the rules don’t settle it, it treats the order as needing auth and asks your coordinator once, and the answer becomes a rule for next time.

How is each auth filed?

The way that payer takes it. Where a payer accepts electronic requests, it’s submitted once your coordinator approves. Where a payer only uses its own portal, your coordinator gets a field-by-field worksheet and pastes back the case number. Fax-only payers get the packet with a cover sheet. All of them are tracked the same way until there’s a decision.

What happens when a request is denied?

Your provider gets a peer-to-peer brief with the payer’s reason, its criteria and what the note shows, and an appeal is drafted with the records and the payer’s own policy. Once your provider or coordinator signs, it’s filed and tracked to a decision against the deadline.

Is it HIPAA compliant?

Yes. Intuo is HIPAA compliant and we sign a BAA with every clinic. Card photos are stored privately, plan details never travel in a text, and every check, submission and decision is logged.

A front desk coordinator welcoming a patient
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