FRONT-END REVENUE CYCLEPrior
Authorization
Request, track and document payer approvals so scheduled procedures, imaging and referrals are not delayed or denied.
OVERVIEW
Approvals that are tracked do not become surprises.
Many services require payer approval before they are performed. We identify which services need authorization, gather the clinical documentation, submit requests, follow up with payers and record every reference number and expiry date in one place.
- Identification of services that need authorization
- Request preparation with supporting documentation
- Payer follow-up until a decision is received
- Approval numbers, dates and units tracked
Important: Payer rules, code sets and regulations change often. We confirm current requirements for your payers and specialty during onboarding.
BEFORE WE START
What to have ready
- List of services that usually need authorization
- Payer portal access and fax or phone details
- Who provides clinical documentation
- Typical lead time before procedures
COMMON QUESTIONS
Frequently asked questions
Do you handle peer-to-peer reviews?
We prepare the case and schedule the review. The clinical discussion itself is conducted by your provider.
What if an authorization is denied?
We document the reason, support an appeal with your provider’s input and tell the front desk so the patient can be informed.
NEXT STEP
Free billing assessment ↗Let’s get approvals under control.
Share the services that need authorization and we will outline a workflow.
