Automate The Prior Authorization Process

Healthcare practices can automate the entire prior authorization workflow. From the referral to final payment.

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Automate the Prior Authorization Process

ReferralMD's prior authorization solution uses machine learning and AI-enabled processes which recognize patterns from payer responses. Workflows are dynamically updated to reduce denials and payment delays. Increase efficiency with hands-free processing of revenue cycle process. With seamless payer connections, connect with700+ payers for up-to-date benefits and patient OOP responsibilities. 

With ReferralMD, healthcare practices can automate the entire prior authorization workflow. From the moment a physician refers a patient, all the way to submitting, verifying, and tracking a prior authorization. Seamlessly integrated with your existing systems and workflows.

No need to manually cut and past data from portals. No need to fax forms, play phone tag or sift through emails. ReferralMD connects directly with your EHR, LIMS, pharmacy management or revenue cycle solution.

  • Reduce manual effort by up to 70% and eliminate rework by up to 90%
  • Capture most accurate patient responsibility data to improve collections at point of service
  • Reduce turnaround time by >90% to respond to referring physicians and patients in minutes
  • >25% productivity gains <6 months by eliminating siloed, tribal knowledge-bases
  • Reduce denials and improve payer collections by over 20%

Learn more about our prior authorization solution

About ReferralMD

ReferralMD has been providing patient access, engagement, and care coordination solutions since 2012.  The company founders launched the company to cure the communication breakdown between providers, networks, and functional groups.  With almost one out of two patients not receiving adequate care due to poor communication between health systems, ReferralMD’s solutions for communication improvements realize significant improvements in quality of care,  reduction of leakage of patients from systems, and improved revenue.

Our goal is to build a solution with which individual practitioners, PCPs, enterprise health systems, hospitals, payers, and self-insured employers can route patients to the best and most appropriate provider while providing comprehensive patient communication and support.  In addition, we have strived to replace and improve the ubiquitous fax-based referral systems without disrupting the existing processes of referring providers.

Since ReferralMD went live we’ve been improving practitioner communication and patient care in demonstrably measurable ways.  From our beginnings as a referral management company, to adding our patient-provider matching intelligence, to launching our e-consult platform, CRM tools, and patient access platform we’ve stayed true to our core beliefs of improving patient outcomes and delivering an exceptional experience for our customers.