Olive Authorizes

Procedural and medication prior authorizations

Insurance providers require prior authorizations for many procedures and medications. This requirement creates a massive burden for your health system’s staff and your patients. Nurses, doctors, and administrative staff are spending valuable time retrieving faxes, signing into portals, and filling out information over and over again just to get their patients the treatment they need.

This burden is due to systems that aren’t integrated, a stone-age process of faxing, filing and logging into multiple pieces of software. Olive Authorizes is our solution to help you turn this burden into a seamless process. Olive will directly connect to your fax machine, your EMR, and insurance portals to initiate prior authorizations for both procedures and medications.

Who / Ambulatory imaging, diagnostics, same-day surgery (ASCs), and acute care settings. Target is either CFO, Rev Cycle, Patient experience, or medical director. All are affected.

Why / Prior authorizations (PAs) are a reality of doing business in healthcare. Whether a patient needs an echocardiogram, an MRI, or a prescription often times a prior authorization is required. Too many times patients show up for a procedure that is not authorized. A few things happen: either the patient waits as the staff works with the insurance company to get a pre-cert, the hospital goes at risk to perform the procedure hoping they get the approval after the fact, or the patient has to reschedule their appointment and come back after the approval is received from the insurance company. In the event that a prior authorization is needed for a medication, a patient has to make multiple trips to their pharmacy and could have to wait days for the authorization to come back for their prescription. Staff at health systems who are trying to provide care to patients are bombarded with faxes and paperwork to make sure their patients get the medication they need. Sometimes, because we are all human, things fall through the cracks and a patient becomes overly frustrated. They blame the hospital and have an overall bad experience, and most importantly are not on a quick path to better health.

How / Before the visit (procedure): Olive logs-in to the EMR and looks at the schedule. She looks for patients who are scheduled for procedures that frequently require pre-approvals from insurers. She then looks for the pre-approval and if it is not there, she looks up the patient’s insurance provider and submits the pre-certification request. When an authorization is returned, Olive puts that approval in the patient’s record. Now, when the patient comes in for a visit, the pre-approval is in the record and the procedure can be performed.

After the visit (procedure) / Olive will generate a report from the EMR of all cases where a prior authorization wasn’t acquired prior to a procedure being performed, Olive will then go through the list, look up the insurance information in the EMR, and submit the prior authorization request to the insurance company. Once the authorization is received, Olive will update the patient’s record and revenue cycle will now be able to successfully bill for the procedure.

Medication / Olive will look at the faxes coming in for any medication PA request from a pharmacy. Once Olive receives a PA fax, she will look up the patient’s information in the EMR and then fill out a prior authorization to the relevant insurance company through the Surescripts portal. Once the authorization is received, Olive will update the system and can fax the approval back to the pharmacy for quick action.

Dealing with PAs costs health systems in several ways. First, the staff hours associated with the huge volume of paperwork. Second, the lost revenue when a procedure was performed and an authorization was never received. Third, the patient experience when they have to wait, or even worse have to reschedule their appointment. Lastly, the lost revenue when an appointment slot is wasted because no PA was acquired prior to the visit.

Olive Verifies

Automated insurance eligibility checks

Olive closes the gap. Too many patients who have insurance coverage default to self-pay. Olive’s job is to stop that. Olive will use state of the art automation and AI capabilities to ensure that if a patient has coverage your Revenue Cycle team knows about it and can successfully submit a claim.

Hospital operations are hard enough. We believe a hospital should never miss a payment or put the patient through a collections experience that is completely avoidable through technology. Olive Verifies is our solution to this pervasive problem.

Who / Revenue Cycle and Patient Registration staff in an ambulatory setting.

Why / Often times, registration staff collects insurance information manually from patients, and then manually checks their benefit information before, during, or after a visit. This process takes an enormous amount of time, almost always generates an overwhelming backlog, and is prone to human error. Typically, unresolved.

How / Before the visit: Olive verifies insurance benefits of patients scheduled for appointments by accessing the schedule and looking up the latest insurance information including eligibility status, deductible, and co-pay, and then writes that information back into the EMR.

After the visit / Olive can produce a report from the EMR of patient encounters, retrieve their insurance information, and check against eligibility portals to make sure the revenue cycle staff has the most up-to-date information.

If a patient’s insurance information is not properly resolved or collected before a bill hits, Olive will check the patient against Medicaid and other relevant portals as a last effort to ensure that patient didn’t have insurance at the time of care before it gets mistakenly moved to self-pay.

Olive can use any ambulatory EMR. Olive can also use eligibility portals such as Availity to complete the insurance lookup.

If the organization doesn’t have a system like Availity, no problem, Olive will check her own internal clearinghouse and use portals to make sure she does the most comprehensive search possible.

We want to help you completely solve this problem, not just provide you a capability. We are committed to make sure Olive is trained on your process and your systems to find coverage for all your patients who have it. Many health systems have hired Olive to help them with this problem. Our experience and technical expertise has made us a market leader in providing AI solutions to close insurance coverage information gaps.

Olive will make your staff’s quality of life better, save huge costs associated with your staff doing this arduous task, save your patients from going through a burdensome, embarrassing, and avoidable collections process, and find revenue that is falling through the information gap today.

Olive verifies your patients’ insurance coverage. By hiring Olive, you will improve your operations, your bottom-line, your staff’s morale, and your patients’ experience with your health system. Hire Olive today and finally put this problem in your rear view mirror.

Olive Updates

Claims status updates

Revenue cycle teams spend an inordinate amount of time checking the status of the claims they’ve submitted to insurance companies. Insurance companies haven’t made this easy either. They all have different portals and different user interfaces. Revenue cycle staff has to log in to dozens of systems to check thousands of claim statuses just to find out which claims are getting paid and which ones may need to be worked more to get a successful payment.

Who / Billing and Revenue Cycle.

WHY / Health systems oftentimes treat patients covered by dozens of insurance companies. Not only do they have to figure out the jigsaw puzzle for submitting these claims accurately, they then have to play ”wait, check, wait, check” just to know if the claims are going to get paid. The reality is, highly skilled and trained staff members are spending hours logging into insurance portals and collecting claim status information just so that they can figure out how much money is coming in, when it’s coming in, and what claims they may have to spend more time working through.

How / Olive logs into your insurers’ portals for you. She checks all of your claim statuses and compiles a report for you every single day so you know exactly how much payment to expect and which payments need extra attention.

Olive can work with any insurer’s web portal. If a web portal has a user interface that is unfriendly to our software robot, Olive has several partners she can work with to get the data she needs to make sure her report to you is comprehensive and complete.

Olive Updates is designed to give your staff their time back. Revenue cycle teams are already operating under an avalanche of work. Olive Updates takes a large burden off of your staff and streamlines operations, ultimately resulting in more predictable payments.

Manually checking insurance portals for claim statuses is costing you large amounts of money today. Imagine the amount of other things your staff can be doing when Olive takes over this burdensome task. Not only does it remove hours of wasted human costs, it also ensure nothing falls through
the cracks.

With the exception of Olive, we are all human, and sometimes humans make mistakes. Unfortunately, that can result in a denial that wasn’t caught and a missed opportunity to remedy a claim resulting in lost revenue. Olive Updates wants to help you eliminate this burden on your staff, making their quality of life better and expanding their focus into areas that were traditionally neglected because they didn’t have the time. We think you should get paid for the treatment you perform and you should know if there’s an issue with a claim without having to spend hours sifting through dozens of websites, thousands of claims, and compiling spreadsheet after spreadsheet.

Olive Sorts

Consistently compiles and distributes reports for decision making

I hate to say it, but faxes are still reigning supreme as the secure communication platform of choice in healthcare. That means that your humans have to stand at-the-ready, watching the virtual inbox of the fax. When documents come in, your humans have to figure out what they are, put them in the right folder, or forward it to the right stakeholder. Some organizations get hundreds of faxes every day; some get hundreds of faxes an hour. That’s a lot of time that your humans are spending on something that should be done by computers, and is just another example of how humans are acting as routers… the most expensive routers on the planet.

That’s where Olive comes in. Olive can read each fax that comes in, and make sure they are put in the right folder for action, pushed it to the right stakeholder, and in some cases like prescription prior authorizations, Olive can take care of the whole process without a human involved at all. Let Olive take over and turn your dusty fax machine into an AI-powered information hyperloop.

Olive Manages

Maintains, sets up, and disables inactive Active Directory accounts

As your organization breathes, people come and go. While this is natural, it puts a heavy burden on your IT team to setup new accounts, get rid of old ones, and make sure they aren’t creating duplicate user accounts. Today, this is a very manual process that consumes a big portion of your IT team’s time. You need them focusing on the hard problems, not playing custodian to the ebbs and flows of accounts.

That’s where Olive comes in. Olive has been trained to set up accounts after being triggered by an email of another system, and then constantly cleans up your existing accounts to make sure that there aren’t duplicate or dormant accounts. Olive is like a Roomba for your accounts. Now your IT team can work on that pesky integration…until Olive is hired to do that next.

Olive Extracts

Pulls data from remote EMRs

Many organizations that support providers with a service (like revenue optimization) have their humans logging in to hundreds of remote EMRs and data systems daily to extract the data they need to perform their service. That’s where Olive comes in. Olive is trained to login to remote EMRs and data systems, and extract all the relevant data needed. Now that Olive has that covered, your humans can spend their time focused on what really matters; the patient care you provide.

Olive Valuates

Subrogation valuations

The subrogation process is complex, and involves lots of human hours to value episode and communication valuations back-and-forth with insurance companies. That’s where Olive comes in. We’ve used neural nets to train Olive on how to do subrogation valuations, so she can now join your team and take a huge volume of work off of your humans’ plates.

Olive Engages

Patient engagement

If you’re like most healthcare systems, you have a patient portal. And if you’re like most healthcare systems, not very many patients use the portal. Right now, the process of getting a patient on your portal takes a lot of hand-holding and constant nudges from your humans. That’s where Olive comes in.

Olive can use various methods like email and SMS to help get your patients on your patient portal. Once they’re on, Olive can help engage them with important information, like discharge instructions, normal lab results, and post-visit follow-up. Let Olive help you increase your portal adoption, and increase engagement without your humans having to lift a finger.

Olive Resolves

Finds and reports duplicate medical records

We have an unfair advantage at Olive when it comes to patient matching. It’s core to our history as a company, and we have developed the most sophisticated and accurate patient matching algorithm in the market. The good news is, we’ve built that matching algorithm into Olive’s brain. Olive can go through all of your patient records across all of your EMR systems, and even those from systems you acquire to find any duplicates. This way, you can ensure your patients only have one MRN across multiple systems, and that they are linked, giving you a more comprehensive picture of that patient’s care. The days of sticky notes and backlogs in the medical records office are over—let Olive handle your patient identity resolutions.