Prior Authorization
Solution
Authorization requests initiated, tracked and documented so procedures are not performed against unresolved approvals.
The operational takeaway
No procedure is performed against an unresolved authorization, and the approval detail lands on the claim.
Scope of work
What this service covers
Payer requirement checks by procedure and plan
Submission with clinical documentation packaging
Status tracking, follow-up and expiry monitoring
Peer-to-peer scheduling support
Auth number capture into the claim record
How we work with you
- Pending-auth board reviewed with clinical scheduling
- Documented denial reason when authorization is refused
What you receive
A weekly production and rejection summary, a monthly performance review covering AR ageing, denial categories and collections, and claim-level detail behind every figure — reviewed with the team that operates your account.
