A Physicians office specializing in Bariatrics was dealing with the task of staying on top of the status of the insurance applications and coordinating those efforts with the clients. All the paperwork involved created a paper trail that was not easy to manage. By automating their systems using workflow integration software, they were able to decrease their staff, automate manual duties and reengineer the insurance company’s pre-authorization process.

Streamline and automate the process of obtaining insurance authorization for gastric bypass surgery.

The system allows patients to fill out the application online. The system then calculates key factors in determining whether the applicant is a good candidate for surgery. If it is determined that an opportunity exists an appointment with the patient is scheduled. That information along with information from the doctor’s visit is entered into the software. The software has drop-down lists with all the codes and symptom descriptions built in as well as insurance company addresses and locations. Based on the data entered into the system a letter is generated to each insurance provider listing the reasons surgery is needed. Correspondence to and from the insurance providers is tracked in the system under the patients name. All of the patients information, including letters, phone correspondence, and visits are in one location. When a patient calls in regarding their status an administrative assistant call look them up by name and view their entire history without leaving their desk. Notifications flag overdue tasks or calls. The system balances the workload throughout the office by allowing any staff at any time to view the process of clients. Administrators can schedule surgery times and anticipate demand by viewing reports of the status of clients by how far they have progressed through the system. The software drastically increases productivity levels of new employees by managing the process and notifying them of pending tasks.