Prior authorization
The approvals chased before the visit, not after the denial. We check what needs authorizing, file it with the documentation attached, and work the queue until a decision lands.
What it covers
- Every scheduled service checked against the patient's plan
- Requests filed with the clinical notes the payer asks for
- Payer portals and phone queues worked daily, not weekly
- Peer-to-peer reviews scheduled and prepared for
- Approvals, visit counts, and end dates tracked in one place
- Renewals opened before the current authorization runs out
How it works
Check before the visit
Every scheduled service is checked against the plan, so nothing reaches the room without the authorization it needs.
File and chase
Clinical notes gathered, the request filed with the payer, and the queue worked daily until a decision lands.
Track to expiry
Approvals, visit counts, and end dates tracked, with renewals opened before the current authorization runs out.
Who it is for
Practices where authorizations are handled between patients, and the first sign of a missed one is a denial weeks later.
Questions we get
Which services do you check for authorization?
Every scheduled service on the calendar, checked against the patient's plan rather than spot-checked. Anything that needs an authorization is flagged before the visit, while there is still time to act.
Do you handle peer-to-peer reviews?
Yes. We schedule them and prepare the clinical documentation the payer asks for, so the provider goes into the call with what they need.
What happens when an authorization is denied?
It goes to appeal with the documentation attached, and the reason is traced back so the same denial stops recurring. Appeals are part of the same cycle, not a separate engagement.