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.
I have been a very satisfied client with Practolytics for nearly 5 years now. As you would expect, they are collecting the money that we have worked so hard for. We like the fact that they share our passion for data. We both approach our common issue i.e., how to collect money from a data centric viewpoint, and this drives improvement. The team is always willing to listen to us and make changes if necessary. Through the years we have asked for help with various office activities from credentialing to prior authorizations to procurement of outside medical records. Yes, these were add on-services, but outsourcing these activities to their team has been a winning solution that has intertwined the billing team into the success of our practice. These add ons have been a good value for us too. Lastly, we have easy access to one of the principal partners on the billing team, and the response time has always been excellent. Thank you! Practolytics!
We have been working with Manik and the rest of his team since August 2015. At that time, we were a clinic in need of guidance, in terms of credentialing, understanding the claims process and optimizing the use of the technology and stabilizing cash-flow. The team as a whole spent many hours upfront working to get everything moving smoothly and also developing relationships with most insurance companies. Manik’s hard work & dedication paid off as our practice more than tripled in visits, and we no longer had to tell the patients that we aren’t in the network. This more than anything has allowed us great patient flow and continued steady growth.
We are a solo orthopedic practice in North Carolina and our relationship with Practolytics started in June 2015. They have staff members who are always willing to help. They work very hard to make us happy and I appreciate all that they do on a daily basis. They take out the worry of getting payments and always follow up with insurance companies. I found the customer service to be unsurpassed. All phone calls are returned and our questions are answered in a thorough and timely manner. The monthly reports are easy to read and provide a quick assessment of the health of the practice, including the company’s account receivables. When I need advice or am unsure of something, it gives me comfort to know that they are just a phone call away. Switching to Practolytics was truly one of the best decisions that I have made for our practice. I truly look forward to a longtime relationship with the staff at Practolytics.
I started a new practice approximately 5 years ago. I have used Practolytics for my billing services over this entire period. I have also used them for integration of collections, adding new providers and DME. They have been excellent and are also part of the reason why I am so successful. They are very knowledgeable about billing. I not only see patients in clinic but also at the hospital and nursing home and also do surgical procedures in and out of the office. I have been very impressed with their level of skill and knowledge. They also do very good on communication. I would highly recommend them for any of your billing needs.