Pre Authorization
The prior authorization process is an essential element of medical diagnoses and procedures especially when the claims have to be paid with an insurer. It’s the process of obtaining an authorization from the insurance company to provide specific medical services. Insuring that the insurance carrier has a nod from payer in advance means that there are better chances of a smooth settlement of claims. The procedure involves obtaining an authorization number which has to be added to the claim when it is submitted.
Our pre-authorization assistance services assist institutions, hospitals and outpatient clinics, and physician practices in:
- Request an insurance approval to perform procedures or services that need prior authorization
- You can save time and reduce the stress of managing the payers
- Staff can concentrate on their core tasks
- Claim maximum reimbursement
Get Your Precertification Process handled by experts
Certain managed care plans and points of service programs as well as Medicare or Medicaid require preauthorization for procedures like surgery, hospital admissions as well as some outpatient procedures. The failure to obtain preauthorization prior to procedures required by the payer could result in massive costs to the provider.
As a prior-authorization service is a trusted partner, you can rest at ease knowing that the entire process associated with the present process will be handled efficiently. Our team of prior-authorization experts will work together with your office in order to ensure that:
- Treatments, as well as services that demand prior authorization, are filed promptly
- You’ve met the requirements of the payer prior to you can submit a prior authorization request
We will ensure that the precepts are filed with the following:
- The insurance of the patient and the patient’s demographic information
- A written or verbal order from the physician who refers you to
- The primary health care provider to the doctor conducting the exam, if required
- A detailed diagnosis, thorough clinical indication, medical history, as well as the reasons for the examination
- Days or sessions of hospitalization to be expected for hospital stays as well as extended stays in a facility for care
- ICD-10 along with CPT codes to diagnose procedures and plan treatment
Our assistance will allow you to concentrate on providing prompt medical care to patients while receiving the compensation you deserve in rapid turnaround.
Benefits of Our Pre Authorization Services
- Secure portal on the web to carry through the procedure
- Updates on the pre-certification process completed, or status information
- Reduction in paper work and mistakes
- Reductions in insurance write-offs and denials
- Rapid turnaround time for precertification
- Time to focus on patients’ care
- 30%-40 percent decrease in operational expenses
- No long-term, yearly contracts