Certain medical treatments need to be approved or precertified prior to being performed in order to have them covered by the insurance company. Managing precertification is a tedious and time-consuming task for busy practices. An experienced pre-authorization company, Outsource Strategies International (OSI) offers effective pre-authorization services for the precertification process.
Our pre-authorization services help hospitals, outpatient facilities, and physician practices to:
- Get insurance authorization for procedures and services that require prior approval
- Save valuable time and minimize the hassles of dealing with payers
- Free up staff to focus on core responsibilities
- Claim maximum reimbursement
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Some managed care programs, point of service plans, and Medicare and Medicaid require precertifications for procedures such as hospital admissions, surgeries, and some outpatient procedures. Failure to obtain preauthorization for procedures mandated by the payer can result in huge financial losses to the provider.
As your prior-authorization company, you can rest assured that all the procedures involved in the precert process will be managed efficiently. Our dedicated prior-authorization specialists will work with your office to ensure that:
- Your claims for treatments or services that require preauthorization are submitted promptly
- You have met all of the payer’s criteria before submitting a prior authorization request
We will ensure that precerts are submitted with the following:
- The patient’s insurance and demographic details
- A verbal or written order from the referring physician
- Referral from the primary care physician to the physician ordering the exam, if needed
- Detailed diagnosis, detailed clinical indications, past medical history, and the reason for the requested exam
- Number of sessions or days of inpatient status expected for hospital stays and extended care facility stays
- ICD-10 and CPT codes for diagnostic procedures and planned treatments
Our support will allow you to focus on providing timely patient care as you receive the reimbursement you deserve in quick turnaround time.
Pre Certification Services
- Secure web-based portal for carrying through the process
- Reports on pre-certs completed and/or status updates
- Reduced paperwork and errors
- Reduced insurance write-offs and denials
- Precertification in fast turnaround time
- More time to focus on patient care
- 30% to 40% reduction in operational costs
- No long-term yearly contracts
To learn more about our prior authorization services, call 1-800-670-2809.