Insurance Prior Authorization Services

21+

Years of Experience

30%

Faster Authorization Processing

20%

Decrease in Claim Denial Rates

Simplify Insurance Prior Authorizations!

Providers require insurance prior authorization to provide certain specialized services and procedures. Also referred to as pre-authorization, it can be time-consuming. Let’s simplify this process.

Focus on patient care, ensure timely insurance approvals, and improve revenue and practice efficiency with our services. We presently manage thousands of cases every day.

Outsource Pre-Authorizations and Improve your Practice’s Efficiency!

Speak to an Expert

Benefits of Expert Insurance Authorization Services

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Expedite the approval process

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Reduce delays in patient care

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Reduce claim denials

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Improve financial health

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Improve patient experience

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Reduce administrative costs

Benefits of Outsourcing Insurance Authorization Services

Who We Are

We are experts at providing comprehensive authorization services to all medical specialties. Having a team that has experience in multiple specialties allows us to manage authorization for most specialties, practices and settings.

Experts Since 2002

Our insurance prior authorization company has been providing these services for more than two decades for all specialties, including:

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Radiology

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General Surgery

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Vascular Surgery

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Urology

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Ophthalmology

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Neurology

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Chiropractic

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Orthopedic

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And more

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We serve all 50 states

How are our Insurance Prior Authorization Services Priced?

We understand that every office is different and requirements for each office might differ. We want to be fair, flexible, and transparent with our pricing. Our prior authorization services have a few different ways it can be prices as below.

Full-Time Equivalent

Our pre-authorization service is billed at a fixed rate, equivalent to the cost of employing an FTE for a specified period, typically monthly or annually.

Flat Fee Pricing

Are you a small practice? This could be ideal for you. We guarantee a set number of verifications at a price starting as low as $500 per month.

Transaction Pricing

Ideal for a practice uncertain about its work requirements, this option allows pricing per eligibility request, starting as low as $5.00.

We Can Work on Your EMR

If you want us to work on your software, we can. We presently work on several software.

Live Team

Our team of authorization specialists work as an extension to your office and do authorization through online portals, faxes and when required by calls. They will coordinate information and provide support throughout the day.

Dedicated Communication Channels

We understand the importance of consistent and accurate communication. We prioritize transparency and clarity to keep all stakeholders informed throughout the authorization process.

With our services, you have:

A resolute team and project manager
Timely requests and follow-up
No long-term agreements or contracts
Competitive pricing
Ongoing QA and reporting

Our Prior Authorization Process

Our prior authorization process is a meticulous, multi-step procedure that ensures efficient and timely approval of medical services. We begin by gathering patient and insurance information, followed by a comprehensive verification to confirm eligibility.

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Patient Demographics

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Requesting Authorization

4

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Verification & Eligiblity Check

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Approval Confirmation

5

3

Documentation Preparation

9

Appeal When Needed

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Patient Demographics

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Verification & Eligiblity Check

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Documentation Preparation

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4

Requesting Authorization

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5

Approval Confirmation

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Appeal When Needed

Why Choose Us?

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Proven history of success

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Team skilled in navigating complex processes

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End-to-end solutions, from verification to approval

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Up to date with insurance regulations and guidelines

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Timely approval, reducing patient waiting times

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Exceptional customer care from a resolute support team

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No setup fees or training costs

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No long-term yearly contracts

Healthcare and Dental Revenue Cycle Management Process

Do not Let Delays Hold You Back – Optimize Approvals with Us!

Contact Us Today

FAQs

What is an insurance authorization?

A pre-authorization is a requirement set by your insurance company for certain medications, tests, or health services, necessitating that your doctor obtain permission before your plan will cover the item.

What is the difference between an insurance authorization and an insurance verification?

In essence, insurance verification is the initial step to confirm that a patient has valid insurance and understand coverage details, while insurance authorization is a subsequent requirement for specific services that need pre-approval from the insurance provider.

What does it mean when insurance is authorized?

This refers to a determination made by your health insurer or plan that a healthcare service, treatment plan, prescription medication, or durable medical equipment is deemed medically necessary. It is often referred to as prior authorization, prior approval, or precertification.

Who is responsible for obtaining preauthorization?

If your healthcare provider is in-network, they will initiate the prior authorization process. However, if you choose a provider outside of your plan’s network, you will be responsible for obtaining the prior authorization yourself.

What types of medical procedures or services require authorization?

Surgeries and treatment procedures that are costly or considered non-emergent may require prior authorization. These could include surgeries, diagnostic tests, hospital admissions, DME, procedures and prescription medications.

How can insurance authorization services benefit my healthcare practice?

Insurance authorization services save claim processing time and improve overall flow. We also increase the chances of timely approvals, thereby enhancing practice revenue and improving the overall patient experience.

Can you work on our software?

We can work independently on your software, review your schedule, do verifications and authorizations, update authorization notes to keep you fully aware prior to patients visit or procedure.

Do you provide coverage in all US states?

Yes, we do.

What are your contract terms?

Contracts are generally 30 days. We believe in you staying with us and being confident with our services. As we like to say, “We will earn your business.”

How do we know that you are experienced in our specialty?

When it comes to authorization, we have experience in all specialties and nuances of each one. We are presently providing services to more than twenty specialties.
Do not take our word for it. Ask us about our free trial and make sure you are comfortable with our capabilities.

What is the typical time limit for an authorization request?

Same day. We do not like to wait to request for authorization.

Will using prior authorization services increase my practice's compliance with insurance regulations?

Yes, by partnering with us, your practice can stay up to date with insurance regulations and guidelines. We ensure that authorization requests comply with all necessary requirements.

Do you manage authorization for all insurances?

Yes, we do.

What happens if the insurance company denies the authorization request?

If the paperwork is correct, we normally do not see a denial. But in case of a denial, we will start an appeal process and continue to follow up until a resolution is reached.

What does your support look like?

We take pride in the support. We have a resolute account manager and team managing your accounts that can reach out to you during working hours. Our team is available by telephone, email as well as direct chats if that is set up to manage the account.