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Streamline Your Prior Authorization Process with GEMMS ONE

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GEMMS

At GEMMS ONE, we understand the complexities and challenges that come with managing prior authorizations. That’s why we’ve partnered with Fast Staff, a leading full-service prior authorization vendor, to bring you an innovative and comprehensive solution designed to transform your practice’s efficiency and patient care. 

Imagine a world where your administrative burdens are significantly reduced, allowing you to focus more on what matters most: providing exceptional patient care. With GEMMS ONE Pre-Authorization Product, this world is within reach. 

Key Features

Real-Time Eligibility and Benefits:

Our service covers 80-90% of payers in any given market, ensuring comprehensive verification of insurance coverage and service level benefits.

Receive real-time procedure code authorization requirements, drastically reducing errors and denials. Picture your team effortlessly navigating through prior authorizations with confidence and precision.

Cost Estimates

Easily upload your fee schedules into our system to create accurate out-of-pocket estimates for patients. No more guesswork—just clear, concise cost information delivered straight to your patients.

Generate estimates for in-network, out-of-network, and self-pay patients. These estimates are not only accurate but also automatically saved to patient charts in GEMMS ONE, ensuring transparency and preparedness.

Authorization Submission

Whether your practice specializes in radiology or cardiology, our solution fully supports both fields, making it versatile and robust.

Let our RPA technology handle the repetitive tasks of payer portal logins and authorization processes. User interaction is only required for essential clinical document uploads or questionnaire completions. Imagine the time saved and errors avoided through intelligent automation.

Authorization Status and Documentation

 Our system continuously checks and updates authorization statuses, saving eligibility results, cost estimates, and authorization documents to patient charts. Visualize a seamless workflow where all necessary documentation is automatically handled and organized.

We provide comprehensive proof of authorization for appeals and claims processing, giving you the backup you need to confidently manage any disputes.

User Interface and Workflow Integration

Launch the prior authorization module from decision trees, custom buttons, or dashboards within GEMMS ONE. Our integration is designed to adapt to your existing workflows, not the other way around.

Enjoy a single-pane view that displays both eligibility and authorization information, making it easier than ever to stay on top of each patient’s needs.

Automated Authorization Submission

Automate requests to payer websites with our advanced bot technology, requiring human input only when necessary.

Experience the ease of a fully automated process that handles scheduling and authorization, with approvals returning without human intervention. Our solution is always adapting to regulatory requirements, ensuring compliance and efficiency.

Patient Engagement and Payment Processing

Deliver cost estimates directly to patients via text or email, integrating with patient engagement apps to enhance communication and transparency.

Enable patients to make real-time payments using various methods, with transactions posting automatically in GEMMS ONE . Streamline both pre-visit estimated payments and post-visit balance collections, providing a seamless financial experience for your patients.

Benefits of Prior Authorization Process

Efficiency and Accuracy

Streamline the authorization process, significantly reducing manual checks and errors. Provide real-time data for accurate scheduling and improved patient care. Imagine your team working more efficiently, with fewer administrative hurdles and more focus on patient outcomes.

Patient Satisfaction

Offer clear, accurate cost estimates to patients, ensuring they are well-informed and prepared for their financial responsibilities. Facilitate easy pre-visit and post-visit payments, enhancing the overall patient experience. Picture your patients feeling more confident and satisfied with their care.

Operational Insights

Gain valuable analytics on payer turnaround times, staff productivity, and denial rates. Identify trends and optimize your operational efficiency, allowing for data-driven decision-making and continuous improvement.