Problem Statement

Coverage and benefit details must be confirmed and entered accurately before billing, and doing this manually at volume is slow and error-prone. When a patient changes insurance, the old plan can remain on file alongside the new one, and an overlapping inactive coverage can auto-authorize referrals against a plan that will never pay. Left in place, these stale coverages drive authorization denials and avoidable rework.

Automation Solution

This automation removes old, overlapping inactive coverages in Epic when patients change insurance to prevent auto-authorization of referrals on non-active plans.