21+
Years of Experience
30%
Faster Authorization Processing
20%
Decrease in Claim Denial Rates
Simplify Insurance Prior Authorizations!
Providers require insurance pre-authorization to provide certain specialized services and procedures. Also referred to as prior authorization, the process can be time-consuming and resource-exhaustive.
Simplify your insurance authorization process with us. We specialize in insurance prior authorization services that reduce your administrative burden, mitigate delays, and support faster patient care delivery.
Benefits of Expert Insurance Authorization Services
Accelerate the approval process
Less delays in patient care
Minimize claim denials
Enhance financial health
Provide better patient experience
Reduce administrative costs
Who We Are
With over two decades of experience, we handle prior authorization services for all medical specialties and settings. Our experience in this field enables us to handle thousands of authorizations every day – for outpatient, inpatient and specialty care.
Experts Since 2002
Our insurance prior authorization company has been providing these services for more than two decades for all specialties, including:
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 and Experienced Authorization Team
Our team of certified specialists work as an extension of your office and handle tasks such as initiating, monitoring and following-up on authorizations, so that you can focus on your core strategic functions.
We leverage payer-specific portals and processes, handle calls with the insurance companies when necessary, and coordinate promptly with your front-office/billing staff to seamlessly get things done.
Dedicated Communication Channels
We understand the significance of consistent and accurate communication. We prioritize transparency and clarity to keep all providers or clients informed throughout the authorization process. We ensure clear, consistent communication through:
- A dedicated authorization team and project manager
- Shared email threads, ticketing systems, or secure messaging
- Daily status updates and escalations as required
- Regular QA, audits, and performance reporting
Transparency is key to the efficacy of our process.
Our Proven Insurance Authorization Workflow
Our comprehensive insurance authorization services follow a proven, step-by-step process that prioritizes speed, accuracy, and compliance.
1
Patient Demographics
Requesting Authorization
4
2
Verification & Eligiblity Check
Approval Confirmation
5
3
Documentation Preparation
Appeal When Needed
6
1
Patient Demographics
2
Verification & Eligiblity Check
3
Documentation Preparation
4
Requesting Authorization
5
Approval Confirmation
6
Appeal When Needed
- Patient Demographics Collection
We promptly collate all essential information to initiate the authorization. - Verification & Eligibility Check
Diligently validate the patient’s insurance plan coverage and policy details. - Documentation Preparation
Ensure complete, compliant submission to payers by organizing records. - Requesting Authorization
Initiate process with the insurer through payer portals, fax, or direct phone call. - Approval Confirmation
Obtain and document approval or required additional steps. - Appeals (When Needed)
Process denials with a structured and efficient appeals process.
Why Choose Us?
Proven track record
Skilled in navigating payer-specific rules and denials
End-to-end insurance authorization services
Up to date with the latest insurance regulations
Improved revenue cycle support
Real-time reporting and performance reviews
No training or onboarding cost
Frequently Asked Questions (FAQs)
What is an insurance authorization?
Insurance authorization, also known as pre-auth or prior authorization, is the process of obtaining approval from a health insurance company before delivering specific healthcare services or medications. This ensures that the service is medically necessary and covered under the patient’s insurance plan.
What is the difference between insurance authorization and insurance verification?
Insurance verification confirms a patient’s insurance coverage, eligibility, and plan benefits. Meanwhile insurance authorization is about seeking approval from the insurance provider for specific treatment/procedure that requires prior consent before they can be performed.
What does it mean when insurance is authorized?
When insurance is authorized, it means the insurer has reviewed the request and approved the requested service or procedure as relevant and eligible for coverage. This eliminates any claim denial possibilities and ensures timely reimbursement.
Who is responsible for obtaining preauthorization?
In most cases, the healthcare provider is responsible for initiating and obtaining insurance pre-authorization. Practices often outsource this process to specialized insurance authorization services providers to reduce administrative workload and avoid costly delays.
What types of medical procedures or services require authorization?
Many health plans require prior authorization for high-cost or specialized services such as:
- Advanced imaging (MRI, CT scans)
- Surgeries
- Specialty medications
- Durable medical equipment (DME)
- Behavioral health services
- Physical or occupational therapy
Do your services help reduce claim denials?
Absolutely! Our comprehensive prior authorization services ensure that all payer requirements are met, significantly lowering the chance of claim denials and payment delays.
What is the typical time limit for an authorization request?
Turnaround time depends entirely on payer and service type. Nevertheless, we aim for fast and accurate submissions, with regular follow-ups and escalation protocols in place to reduce delays.
Do you manage authorizations for all insurance companies?
Yes, we work with all major commercial payers, Medicare, Medicaid, and smaller regional insurers. Our team is always updated on evolving payer requirements, facilitating smooth processing.
What happens if the insurance company denies the authorization request?
If a request is denied, we analyze the denial reason, prepare additional documentation if needed, and initiate an appeal on your behalf. Our team works closely with providers to ensure that appeals are submitted thoroughly and timely.
What kind of support do you offer during the authorization process?
You’ll have access to a live support team, a dedicated account manager, and real-time updates on all requests. We provide consistent communication via email, portals, or preferred channels to keep your team informed.
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