Prior Authorization Services
Delays in authorization cost visits and revenue. We find the requirement, assemble the clinical evidence, submit the request and track it, so scheduling never waits on a payer.
Problems we solve
- Services performed without authorization and denied afterwards
- Requests returned for missing clinical information
- Staff time lost on hold with payers
How it works
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Requirement lookup
We check whether the payer requires authorization for the specific procedure code.
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Documentation package
Clinical notes, imaging and prior treatments are assembled to match payer criteria.
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Submission and follow-up
The request is submitted and tracked, with reference numbers and decision dates recorded.
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Appeals
If a request is denied we request the reason in writing and support peer-to-peer review or appeal.
What you will see in reporting
- Requests submitted, approved and denied
- Average time to decision by payer
- Denials avoided through up-front checks
Who it suits
Ideal for specialties with frequent imaging, procedures or high-cost treatments.
Specialties we support
- Primary Care
- Dental Practices
- Orthopedics
- Cardiology
- Mental Health
- MSOs & DSOs
- Urgent Care
- Dermatology
- Physical Therapy
- Ophthalmology & Optometry
Related guides
A Prior Authorization Checklist for Busy Clinics
A repeatable checklist to prevent authorization denials: what to check, what to send and how to track decisions.
2 min read
Understanding Common Denial Codes (CO-16, CO-45, CO-97)
What group codes and reason codes mean, the denials you will see most, and how to respond to each.
2 min read
Frequently asked questions
Do you handle retro-authorizations?
Where the payer allows retrospective review we prepare and submit the request.
Can you work from our scheduling system?
Yes. We work from your schedule so authorizations are started before the visit.
Book a free consultation
Tell us about your practice and the support you are looking for. We will arrange your free consultation.