Pennsylvania Hospital Group

The Pennsylvania hospital group was struggling with a low prior authorization success rate, creating delays in patient care and revenue cycle inefficiencies. Managing prior authorizations manually within their Epic PMS environment was time-consuming and created PHI exposure risk.

The hospital group deployed Infinx's AI and automation-powered prior authorization solution integrated directly with their Epic PMS. The solution automated authorization submission workflows while maintaining HIPAA-compliant PHI protections across all payer connections.

The organization achieved a 95% successful prior authorization rate, significantly reducing denials and delays. PHI was protected throughout the automated workflow, satisfying compliance requirements while improving operational throughput.

• Integrating prior auth automation natively within Epic PMS reduces staff burden without requiring workflow changes.
• Maintaining PHI protections in automation pipelines is achievable and necessary for compliance-sensitive hospital groups.
• High authorization approval rates directly reduce downstream denials and accelerate revenue collection.