Prior Authorization and Notification
What service we provide in Pre-Authorization?
We are here to ensure that your pre-authorization needs are met with precision and care with latest and most recent requirements for pre-authorization in medical billing. Our team efficiently initiates prior authorization requests, securing treatment approvals through online portals, faxes and direct communication with payers.
We’ve designed our process to help you seamlessly submit and verify your prior authorizations and advance notifications in real time.
Our team of pre-authorization experts can help you with:
• Obtaining the correct CPT codes for the anticipated services.
• Improving claims processing, and increasing on-time payments.
• End-to-end communication and pre- authorization management.
Also Known As
Prior authorization is also known as precertification, predetermination, and pre-approval.
What is Prior Authorization?
Prior authorization requires the healthcare professional to get insurance company approval before starting the treatment or issuing a prescription. It requires offering full details on the patient’s condition and planned intervention. The insurance company then compares this data to their coverage policies and clinical criteria to assess whether the service is needed.
Importance Of Prior Authorization In Patient Care And Billing
Understanding this procedure is critical for patients because it affects their ability to receive timely medical care and pay for it. Prior authorization plays a critical role in patient care and billing. It becomes a vital crossroads where medical care and health insurance intersect, ensuring patients obtain the required treatments while conforming to their health plan’s cost structures.