Orthopedic Group Increases Revenue with Automated Prior Authorizations

This case study details the implementation of Infinx's Prior Authorization Software (IPA) by a large orthopedic group on the east coast, which includes over 70 providers across 11 locations. The orthopedic group faced significant revenue leakage due to delayed prior authorizations, which resulted in patients seeking care from competitors. To address this issue, the group adopted IPA to automate their prior authorization workflow. The software successfully automated over 60% of manual tasks, utilizing machine learning and artificial intelligence to streamline the process. As a result, the group experienced a $55,000 increase in quarterly revenue within the first three months, along with a 50% reduction in denial rates. The implementation also improved staff productivity, saving over 80 hours per week, which equates to approximately $100,000 annually in administrative costs. The case study highlights the operational efficiencies gained through the use of IPA, including enhanced turnaround times for prior authorizations and improved patient access to necessary diagnostic studies.