Stop Treatment Delays and Prevent “No Auth” Denials Before They Happen.
Struggling to get timely approvals from payers? Or don’t have time or team for aggressive follow-ups with payers? Our prior authorization (PA) medical billing saves you from such roadblocks and provides confirmations in advance to avoid last-minute confusion.
Prior authorization delays are frustrating, costly, and avoidable. Our Healthcare prior authorization outsourcing handles them efficiently, so your revenue never slips through cracks.
Our PA billing and approval services are built to maximize approvals for high-cost procedures. We follow HIPAA-compliant workflows that meet the highest security standards so you can provide care confidently, without delays or the risk of denials.
We verify benefit limits and "Auth Required" lists in real-time. If a procedure doesn't need auth, we save proof of that policy to prevent future recoupments.
We don't just forward notes; we audit them. We ensure physician notes, lab results, and conservative therapy history match the payer's Medical Necessity Guidelines (e.g., InterQual or MCG criteria).
We don't wait for the mail. Our bots check payer portals every 4 hours for status updates, and our staff calls directly to escalate urgent cases.
If a request is denied, we schedule Peer-to-Peer reviews between your physician and the payer's medical director to overturn the decision immediately.
Step Therapy Fails
We document patient history to prove "failed prior treatments," bypassing fail-first rules for expensive drugs.
Missing Documentation
We audit the packet against InterQual/MCG guidelines before submission.
CPT Mismatch
We verify the CPT matches the scheduled procedure and the diagnosis code (ICD-10) supports it.
Retro-Active Issues
Missed the window? We have a specialized team that fights for Retro-Authorizations on urgent cases.
Our specialized team handles complex prior authorization management for healthcare providers, allowing them to focus solely on patient care.
Our specialized team handles complex prior authorization management for healthcare providers, allowing them to focus solely on patient care.
By combining specialty-specific coding, accurate documentation, and real-time payer engagement, we streamline the workflow so approvals come faster.
With our payer-specific prior authorization workflows, we resolve every PA issue. This eliminates waiting periods and ensures smooth services for patients.
Seamless connectivity with central systems.
Let’s discuss how our proven system can recover lost revenue and free your team from the burden of prior authorization.
Caths, Echoes, Implants.
Joint Replacements, Spinal Surgery
Chemotherapy, Radiation treatment plans
Advanced Imaging (MRI/CT)
Injections, Stimulators
Endoscopies, Biologics
