The Authorization Bottleneck
Insurance authorization is where DME orders go to die. Providers speak in clinical terms, payers speak in billing codes, and suppliers are stuck in the middle. Your staff spends hours on hold, navigating payer portals, and playing phone tag—often over misunderstandings that could be resolved in minutes if everyone were on the same call.
Our Solution: DMEAid creates three-way conferences that connect all parties simultaneously, with AI translating between clinical and billing terminology in real-time.
Dynamic Conference Bridging
When authorization issues arise, DMEAid can initiate conferences connecting:
- Healthcare Provider: The ordering clinician or their staff
- DME Supplier: Equipment fulfillment representative
- Insurance Payer: Prior authorization department
All parties join a single call—no more back-and-forth phone tag.
Real-Time Terminology Translation
The biggest barrier to authorization isn't hold times—it's miscommunication. DMEAid bridges the language gap:
- Clinical to Billing: "Progressive muscle weakness" → ICD-10 M62.50
- Equipment to HCPCS: "Hospital bed with rails" → E0260
- Coverage Requirements: Payer-specific documentation needs surfaced in real-time
How It Works
- Issue Detection: DMEAid identifies authorization blockers automatically
- Conference Initiation: AI coordinates scheduling with all parties
- Live Transcription: Conversation captured and analyzed in real-time
- Code Extraction: Relevant codes and requirements pulled from discussion
- Resolution Documentation: Outcomes recorded with full audit trail
Sub-500ms Translation
Speed matters in live conversations. Our NLP engine delivers:
- Code lookups in under 500 milliseconds
- Real-time suggestions displayed to all parties
- Instant coverage determination queries
- Automatic documentation of agreed terms
Results
- Authorization in under 5 minutes vs. 3-5 days industry standard
- 95% first-pass approval rate with proper documentation
- 85%+ successful conference completion when mediation is needed
- Zero staff hold time—DMEAid manages payer communication