Preventing Front-End Denials
Authorization issues are the number one cause of preventable denials. Our Authorization Management service acts as a firewall, ensuring that no non-emergency procedure is performed without a secured approval number. We verify patient eligibility and benefits 48-72 hours prior to the appointment, confirming deductible status and co-pay amounts to ensure financial transparency.
Retro-Authorization Support
In cases of emergency admissions or urgent transfers where prior authorization isn't possible, time is of the essence. Our team is skilled in obtaining retro-authorizations within the payer's strict time windows (usually 24-48 hours post-admission). We compile the necessary clinical evidence to prove medical necessity, protecting the facility from costly write-offs.
Online Portal Management
Navigating dozens of different insurance portals (Availity, Optum, etc.) is time-consuming for your front desk staff. We take over this burden completely. Our specialists log in, submit clinical documentation, track the status of the request, and upload the final approval directly into your Electronic Health Record (EHR/EMR) system, ensuring a seamless experience for both staff and patients.