Prior Authorization Management
Prior auth shouldn't delay care or kill claims. We submit, escalate, and secure authorizations before the date of service — and capture every reference number in the chart so the claim never denies for missing auth.
98%
Prior auth approval rate
Across commercial and government payers
< 48h
Average turnaround
Standard requests, with urgent fast-track available
0
No-auth denials on active clients
We capture the auth before claims drop
A disciplined approach to prior authorization management
Prior authorization is one of the most expensive administrative burdens in healthcare. Done wrong, it delays patient care, fragments your scheduling, and turns into a long tail of avoidable denials.
Our auth team owns the entire workflow: identifying which CPTs need auth by payer, gathering clinical documentation, submitting through the right channel (portal, fax, phone), aggressive follow-up, peer-to-peer coordination when needed, and final delivery of an approved reference number into the patient chart before the date of service.
What makes our prior authorization management different
Six advantages your team feels in the first 30 days.
Procedure-to-payer matrix
We maintain an up-to-date matrix of what requires auth by CPT and payer — so nothing gets missed.
Clinical packet builder
We pull the right notes, labs, and imaging to support medical necessity on the first submission.
Pre-DOS guarantee
Auths secured before the date of service, or escalated to peer-to-peer review immediately.
Peer-to-peer coordination
We schedule peer-to-peers with the physician and prep the talking points.
Auth tracking dashboard
Every request, every status, every reference number — visible to your team.
Reference numbers in the chart
Approved auths are written back to the patient chart so claims drop with the auth attached.
Everything inside the Prior Authorization Management engagement
One flat scope. No surprises. No nickel-and-diming for the work that actually moves revenue.
Backed by our service guarantee
If our work doesn't move the metric in 90 days, we don't charge for the next month. Simple.
- Auth-requirement check on every scheduled procedure by payer and CPT
- Clinical documentation gathering and packet preparation
- Submission via payer portal, fax, or phone
- Daily status follow-up until approval
- Peer-to-peer scheduling and physician prep
- Denial appeals with additional clinical documentation
- Reference number written back to the patient chart / PM system
- Urgent / STAT auth fast-track lane
- Weekly auth performance report
Our process, end-to-end
Five repeatable steps. No black-box. You see every handoff.
Identify
Every scheduled procedure is checked against our payer-CPT matrix to flag what needs auth.
Package
Clinical notes, labs, imaging, and supporting documentation pulled into a payer-ready packet.
Submit
Submission through the right channel — portal where possible, fax/phone where required.
Pursue
Daily follow-up on every open request. Peer-to-peer scheduled within 24 hours if needed.
Close the loop
Approved reference number written back into the patient chart before the date of service.
“We stopped writing off auth-related denials entirely. The team has every reference number in the chart before the patient is even checked in. It's the most reliable workflow in our cycle.”
Dr. Rohit P.
Medical Director · Imaging center, IL
HIPAA
Compliant workflow with BAA
US-Based
Operations and oversight
Encrypted
End-to-end data handling
Audit Trail
Every action logged
Everything you wanted to ask about Prior Authorization Management
Can't find what you need? Ask a specialist.
Pair this service with
Eligibility Verification
Eligibility is the #1 reason claims get denied. We verify every patient before they walk in — active coverage, deductible, co-insurance, and benefit limits — so front desk knows what to collect and billing knows the claim will pay.
Learn more →
Denial Management
Denials aren't an ending — they're a starting point. We work every denial within 24 hours, file structured appeals, root-cause the trend, and rewire your front-end so the same denial doesn't happen again next month.
Learn more →
Provider Credentialing
Credentialing delays cost real revenue — every week a provider isn't on a panel is a week of unbillable visits. Our team gets providers enrolled faster, keeps CAQH attested, and never lets a recredentialing date slip.
Learn more →
See what prior authorization management
should be doing for you.
30 minutes with a specialist. We'll review your current performance, surface the top three opportunities, and tell you exactly what we'd change. No sales pitch.