Pre-Authorization Services

Certain non-emergency medical procedures require pre-authorization services for the healthcare organization to receive payments smoothly. Most insurance companies now refer to it as ‘prior authorization Services.

With this process, the physicians and clinical pharmacists at the insurance company get a chance to review whether the suggested procedure is medically necessary for a patient’s care.

Once approval is received from the payor, the provider and the patient can comfortably proceed with the treatment or service without any major risk of payment denial.

Pre-Authorization Services in Medical RCM – We can help you with: 

  • Verification of the validity of coverage, eligibility, and benefits.
  • Preparing and submitting all the required paperwork for the patient.
  • Expert filling of appropriate criteria sheets and forms.
  • Follow up on preauthorization requests with the payors.
  • Updating the provider immediately upon receiving approval or any issues in the process.
  • Updating patient accounts.

Benefits of Choosing From Pre-Authorization Services Astron EHS 

  • Between the tasks of practice administration and patient care, physicians find it difficult to handle pre-authorizations as well through our pre-authorization services. Our medical billing specialists are well equipped to take this time-consuming process off your hands.
  • We have experience in working with all commercial payers like Humana, Aetna, Cigna,  United Healthcare, and more for prior authorization of medical procedures and prescriptions.
  • With our services, you can reduce coverage errors, minimize clearinghouse rejections or payment denials, improve write-off scores, etc.
  • Providers see an increase in revenue and an organized revenue cycle when associated with us. – Our verification and prior authorization services specialists are constantly updated and trained for optimized Medical RCM services.