An outpatient surgery room

CASE STUDY

Gramercy Surgery Center saves time on payor calls, gains time for patients

With Infinitus, Gramercy Surgery Center now saves thousands of hours a year on verification calls while improving the patient experience and scaling for growth – here’s how.

Challenge

Insurance companies’ online systems for benefit verification and prior authorization are often outdated, require additional communications, or integrate necessary data incompletely – posing a challenge for New York’s Gramercy Surgery Center (GSC). The additional phone calls took time away from higher-value tasks, but were necessary before any care could proceed. The resulting drain on employee time was impeding GSC’s growth — including its plans to expand outpatient services at its Manhattan and Queens centers.

Solution

GSC partnered with Infinitus to automate the tedious and time-consuming tasks of insurance verification and prior authorization across its care sites, leveraging Infinitus’ AI-based digital assistant, Eva. The teams did this by training Eva on the various scripts required to verify a patient’s insurance benefits across the most common payors that service members in GSC’s market area.

Outcome

15-30 minutes saved on each call to payors

Fewer billing surprises thanks to AI benefit verification

More time for patient care, less time needed for admin

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gramercy surgery center logo

“Insurance verification is a critical step in the patient care process, but it’s time consuming and requires human intervention. Infinitus stands out because it attacks the problem from the most common modality that must be used for insurance benefit verification — phone calls.”

Austin Cheng of Gramercy Surgery Center

Austin Cheng

CEO, Gramercy Surgery Center

Here’s why it worked

Now, as soon as a patient schedules an appointment with GSC, the Infinitus platform initiates a call to the payor to request benefit verification and details. Eva can interact with live agents or automated systems to collect plan details, network status, surgery code coverage, coordination of benefits, authorization requirements, and prior authorization status. The patient information is pulled from Gramercy’s electronic medical record (EMR) systems, Surgical Information System (SIS), and then plugged back into SIS.

The Infinitus AI call automation platform is compatible with major EMR systems and integrates with payors. And as a bonus, the automated solution often enhances the quality of collected data: Eva can improve benefit verification and prior authorization data accuracy by 10%.

“We are excited to work with Gramercy Surgery Center as the leading independent ambulatory surgery center (ASC) in New York,” said Shyam Rajagopalan, Infinitus’ CTO and co-founder. “We believe that the technology and workflows in the ASC industry — especially around insurance verification — have much room for improvement.

“EHR integrations often take more than a year, but because of the strong engineering partnership between Infinitus and Gramercy and SIS, we were able to make this happen quickly, and therefore deliver value to patients more quickly.”

An improved patient experience – and more

As a digital-first, customer-focused ambulatory surgical center, Gramercy Surgery Center is always looking for ways to use technology to create a better experience for both their patients and their staff. This led them to Infinitus and its intelligent digital assistant Eva.

Partnering with Infinitus has helped GSC deliver a better patient experience and free up staff to spend more time on care – and also helped to streamline its planned expansion. Gramercy has long been recognized for clinical excellence; now the center is working to grow its patient base and expand services by using technology to improve the patient experience, from scheduling to pre-operative medical clearance to billing. Adopting Infinitus — to automate the time-consuming tasks of insurance verification and prior authorization — has empowered GSC to provide a better patient care experience and streamline its planned expansion.

“Infinitus consistently delivers accurate results, allowing us to focus on providing excellent patient care,” said GSC’s CEO Austin Cheng. “With Infinitus, we have an ability to successfully scale the benefit verification process without the need to hire additional staff, which has proven especially important during a time when the labor market has been tumultuous.”

Can Infinitus work for you?

The Infinitus solution for ASCs automates calls to commercial and government payors. With our digital assistant Eva, you can complete tasks including benefit verification and prior authorization follow-up accurately, consistently, and with a faster turnaround.

Infinitus supports over a thousand therapies, procedures, medications and tests. We will work with your team to ensure that one of our standardized offerings aligns with your operating procedures and needs.

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