Prior Authorization
Streamlined approval workflows to reduce patient treatment delays.
About Prior Authorization
Prior authorization delays are one of the top reasons patients don't receive timely care — and one of the top reasons practices lose revenue when services are rendered without it. Managing prior auths manually is slow, labor-intensive, and prone to error.
Our prior authorization team handles all submissions, peer-to-peer review coordination, and appeals for denied authorizations, reducing delays and protecting your revenue.
What's Included
- Authorization requirement identification
- Payer-specific form completion
- Clinical documentation preparation
- Electronic and fax submission
- Status tracking and follow-up
- Peer-to-peer review coordination
- Denial appeal preparation
- Authorization expiration monitoring
- Retroactive authorization requests
- Auth-to-billing reconciliation
How We Do It
- Identify all services requiring prior authorization before scheduling.
- Gather required clinical documentation from the treating provider.
- Submit the prior authorization request via the payer's preferred channel.
- Track submission status and follow up if no response within 3 business days.
- Coordinate peer-to-peer review requests when an authorization is denied.
- Confirm that approved authorizations are linked to the correct billing accounts.
Common Questions
How far in advance do you submit prior auth requests?
We submit as early as possible after scheduling — typically 5 to 7 business days before the service date for non-urgent procedures.
Can you handle urgent or same-day authorization requests?
Yes. We have a process for expedited authorization requests and can escalate to a payer's urgent review line when clinically necessary.
Related Services
Ready to Improve Your Revenue Cycle?
Talk to a billing specialist about how Prior Authorization can work for your practice.
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