The Digital Clinical Assistant is your solution to the prior authorization process. The Digital Clinical Assistant leverages innovative AI technology and a digital workforce to automate the burdensome process within Athenahealth EHR- eliminating the need to learn new tech or add to existing workflows. As a result, the DCA can improve the time to approval by up to 50%, increasing the number of approvals you can process daily. In addition, the DCA can reduce the cost of prior authorization by up to 60% and alleviate the administrative burden on your staff.

Digital Blue is a healthcare consulting and solutions company focused on improving lives through optimized business performance. Our services and solutions empower leaders across the healthcare ecosystem to eliminate inefficiencies, increase productivity and improve patient satisfaction. Client benefits include; increased revenue, reduced operational cost and administrative burden, and improved quality of care. 

Patient access departments are charged with accuracy from the start. 

Challenges—claims denials, returned mail, regulatory burdens and low patient satisfaction—are barriers they face. Solutions that empower registrars and staff with intuitive, consistent workflows and that prepare patients for their financial obligations have been elusive—until now.

True Access™ clearly and accurately fills the gaps in preservice coverage verification and estimation of patients’ financial obligations. Staff gain consistent workflows and patients receive precisely tailored payment options everywhere. True Access includes additional patient access tools for staff to support eligibility and address verification, medical necessity and prior authorization processes.

With True Access from RevSpring, you receive proven solutions that support four critical areas: 

(1) Coverage Determination and Verification,

(2) Claim Denial Prevention,

(3) Patient Financial Readiness and Increased

Collections, and

(4) Tools, Workflows and Reporting for Staff.

Coverage Determination & Verification

Fast, simple and accurate resolution of all patient accounts prior to, or at the point of, service—no matter whether or not patients are insured, uninsured, underinsured and/or qualify for financial assistance. Includes Eligibility, Coverage Verification and Determination, and Medicaid Coverage Discovery.

Claim Denial Prevention

True Access reduces time spent rebilling claims and reduces days in AR by submitting claims correctly from the start. Includes Prior Authorization and Precertification, Medical Necessity and Coordination of Benefits.

Patient Financial Readiness & Increased Collections

Prepare patients for their financial responsibility and empower them to pay precisely what they can, when they can, from anywhere. Accurate estimates, seamlessly 

integrated with RevSpring’s PersonaPay portal, enable patients to manage their balances with confidence. Our hassle-free billing adjustment solution also allows 

providers to confidently request payments in advance.

Tools, Workflows & Reporting for Staff

True Access empowers staff with intuitive workflows and a modern user interface to manage registration quickly and efficiently. Intuitive staff views based on work queues and guided workflows drive consistency and accuracy, saving time for patients and staff. Our tools also allow you to monitor staff performance.

RevSpring leads the market in healthcare engagement and payment solutions that inspire patients to participate in and pay for their healthcare. We’ve built Engage IQ™, the industry’s only connected patient engagement suite designed to coordinate patient interactions from pre-care to post-care to payment. RevSpring’s intelligent, holistic platform puts patient understanding at the center of one connected personal experience, allowing providers to fully optimize patient satisfaction, data accuracy, staff efficiency and financial outcomes. The company’s OmniChannel communications and payment solutions are backed by intelligence, analytics, contextual messaging and user experience best practices. RevSpring was rated #1 for Most New Capabilities in Patient Engagement by KLAS in 2023 and Best in KLAS in Patient Communications in 2024.

Prior Auth Process As-Is

Prescriber opens the EMR and prescribes the prescription.

The pharmacy will notify the prescriber that a prior auth is needed

Prescriber will submit an electronic request for prior authorization through ePA or insurance portals

Prescribers and their staff input patient demographic information and history and answer clinical questions as they come in. 

The staff is constantly checking for status updates

Duplicate requests come in, typically at night and over the weekend. If the PA request isn't completed quickly enough, these must be filtered out manually.

Backlogged workbaskets and data-entry errors cause care gaps and delays in treatment.

Increased administrative burden is the number one cause in provider burnout and a significant cause for loss in revenue

DCA Optimized Prior Auth Process

The Clinician Opens the EMR and prescribes the medication

DCA monitors the EMR and other systems for PA work and kicks off the automated process

DCA auto-triages PAs and removes ALL duplicate requests as they come in

DCA auto-fills forms via APIs and submits the requests for medications it has been configured for based on your practices' volumes

DCA creates a work queue for any encountered exceptions

nurses work only the PA requests or clinical questions that the DCA is not configured for, saving time for high-value work

Based on payer rules, the DCA posts status updates/tasks to EMR and auto-updates status

60% reduction in manual effort

50% improvement in time to approval

100% elimination of duplicate requests

See more patients, improve employee satisfaction/retention, and get home on time!

RevSpring is the only patient access vendor to connect the dots between intake, registration, and payment.