Prior-Authorization

Securing prior authorization is a critical step in the billing process, serving as the gateway to successful claims processing. It ensures timely payments, reduces claim rejections and denials, and streamlines operations.

What We Offer

Daily Updates

We track appointments daily, ensuring up-to-date statuses and no missed procedures, allowing providers to focus on patient care without administrative hassles.

Benefit Verification

Our experts verify insurance coverage and benefits before procedures, securing required authorizations to reduce claim rejections, prevent delays, and ensure seamless patient care.

Efficient Processing

Our skilled team manages the entire prior authorization process, from identifying pre-approval needs to submitting detailed requests, ensuring documentation for payers.

Integrated CDI and Prior-Authorization

Combining CID with prior authorization ensures accurate records and timely pre-approvals, reducing denials and delays so providers can focus on patient care.

Retroactive Authorizations

For unplanned treatments or insurance changes, we secure retroactive authorizations to ensure proper reimbursements and coverage validation.
  • Unplanned Treatments: We authorize unexpected tests or surgeries for reimbursement.
  • Insurance Changes: We manage retroactive authorizations for policy changes to confirm coverage.

Streamlining Appeals for Prior Authorization Denials

We handle denied authorizations by :

  • Reviewing denial letters to understand appeal requirements.
  • Gathering medical records and supporting documents for a strong case.
  • Drafting detailed appeal letters following insurance guidelines .
  • Proactively following up with insurers to expedite reviews .
  • Managing additional steps like peer – to – peer reviews or providing further documentation .
Our prior authorization services are designed to enhance your billing process. With our proactive approach and highly experienced team, we secure all necessary pre-authorizantion smoothly. Our dedication ensures that healthcare providers can focus on delivering quality patient care.