Save time and offer the best to patients
Pre-authorization helps the practice to avoid denials from the insurance on high dollar value procedures. Absence of pre-authorization most likely results in non-payments of the claims. We help you to take over the burden of pre-authorizations by submitting the necessary records and obtaining the pre-authorization 2 days in advance. Our robust and transparent system helps the practice to keep a daily tab on the status of all pre-authorizations which has been initiated by us.
We co-ordinate and handle your back office
As your trusted partner, our team of experts work with all Government and private insurances like Cigna, Humana, Medicare Advantage Plans, Medicaid and all commercial insurances based on the practice protocols.
Our experts initiate the authorization in different ways based on calling and uploading the documentation in the insurance portals. This helps the practice to preauthorize all the procedures in timely manner thus improving the practice cash flow. In case the authorization requires peer to peer review, we alert the practices way ahead of the patient’s scheduled procedure. This helps in avoiding the denial of authorizations.
Our team is well equipped and uses online insurance portals to get all the material to apply for authorizations. Our experience in coordinating with insurance companies gets the job done faster and more efficiently.
FAQs about Pre-Authorization
Which all specialty authorization do you work for?
We work for a wide range of specialities like Pain Management, Podiatry, Orthopedic, Cardiology, OT/PT, Speech Therapy, Mental Health, Dermatology, Rheumatology, Ophthalmology, Endocrinology etc.
Will you notify us if a patient’s authorization is being expired?
Yes, you will get an alert within the PM/EMR system as well as by us when an authorization is to be expired. We also keep a track of this and initiate the prior authorization before they expire.
How long does pre-authorization take?
It typically takes 2-3 days for the charge to be removed from your debit/credit card/bank. From our end it is voided immediately.
Does pre-authorization guarantee payment?
No. It comes with a disclaimer saying, ‘This is not a guarantee of payment’. It totally depends upon the discretion of your insurer
What happens if my insurer denies pre-authorization?
If you think your pre-authorization was wrongly denied, you can always file an appeal with your insurer. This works best when your doctor endorses that the coverage you seek is justified and necessary for your treatment.
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Pre-Authorization – An Emerging Threat that Practice Should Keep a Watch On
As much as there are reasons and benefits to pre-authorization, it has come under so many criticisms. The following are some of the threats pre-authorization pose on practice.