Physician Authorization Services
Some medical treatments need prior authorization before performing them, so the insurance company can cover the fee. However, precertification takes much time. We are an experienced pre-authorization company and offer valuable prior authorization services.
We help in physicians credentialing services USA, outpatient facilities, and hospitals in the following way.
- Obtain insurance authorization for services and procedures that need prior approval.
- Save yourself from the hectic schedule of dealing with the payers and save time.
- Staff can focus on the primary responsibilities.
- Get maximum reimbursement
HAVE YOUR PRIOR AUTHORIZATION PROCESS MANAGED BY PROFESSIONALS
Some Medicare, point-of-service plans and managed care programs need precertification for procedures like outpatient procedures, surgeries, and hospital admissions. The provider can only face significant financial losses if pre-authorization is missing.
We assure you that we will effectively manage the precertification for the procedures. Our prior-authorizations specialists will ensure that:
- Your submitted claims for treatments or services that require pre-authorization properly
- Payers’ criteria before submitting a prior authorization request
We ensure that precertification has to apply with the following:
- The insurance and demographic details of the patient.
- A verbal/ written order from the physician
- Referral of the primary care physician to the physician who orders the exam, if needed
- Detailed diagnosis, past medical history, detailed clinical indications, and the reason for the requested exam
- Number of sessions expected for stays in hospital and extended care facility stays
- ICD-10 and CPT codes for planned treatments and diagnostic procedures