Prior Authorization

Fixing All Your Complex and Time Consuming Prior Authorization Problems

So for a stress free prior authorization process, get in touch with our PriorAuth Online experts and experience a seamless operational along with a customized solution for revenue generation.

PriorAuth Online is a web based authorization platform for all authorization initiation, approval as well as follow-up. Being a one stop destination for more than 20 specialties and providing excellent customized prior authorization solutions, PriorAuth Online is powered by Sunknowledge Services Inc a 2007 medical billing and collection organization.

With more than 100s clientele list and excellent industries reference as an achievement, PriorAuth Online today works as an operational extension support for most of the leading names in this industry.

In fact, our team of experts delivers a unique state of the art support that transpires to improved AR collections, along with 99.9% accuracy rate. Reducing the operational cost by 80% for all our clients during the process, we also offer a flexible solution in business transition by robust reporting according to client’s protocol, (daily/weekly/monthly), no cost dedicated account manager etc. providing a complete operational transparency our experts also ensure 24-48 hr turnaround time in case of denial or rejection.

Even our $1 million Hiscox/Geico Insurance coverage for any errors of Omission & commission, along with our no binding or no lock-up policy is also part of the discussion for many healthcare providers; making us the one stop prior authorization destination.

Detailed Steps Our Expert Follows for Successful Prior Authorization Process:

Authorization initiation- it starts by obtaining information at the first stage, which is necessary for the treatment process. This is followed by authorization initiation. The information that is collected during the process includes patient name, DOB, ordering provider’s name, NPI, Tax ID, address, phone no along with insurance information. We also ensure a proper check on the diagnosis code, units for each service code, if ordering physician is PECOS certifies or not. 

Requesting authorization - this is the most critical part where documentation is been completed accurately collected through fax, call etc after which verified and validated the documentation is done along with the authorization request. In this process, it is important to maintain constant oversight over all prior authorization request that are outstanding. 

Continuous follow-up is made - our second last steps ensure investigating to resolve whether the patient is eligible based on the payer requirements for the prior authorization process. Once this is done prior authorization is initiating through outbound calls, portal etc as per payers’ protocols/guidelines. After then waiting on the approval or denial of their request for ongoing authorization happens. 

Updating the authorization process- This concludes with providing additional documents/ data if requested by the payer. This ends up updating all the prior authorization results in the billing system. 

Ensuring 100% prior authorization submission on the same day and increasing the authorization rate by 1.5-2x, our experts’ guarantees 97% highest first pass collection rate. Being the one stop prior authorization destination, our team also excels in providing task specific services including:

  • Order entry (patients, providers, insurance, items, etc)
  • Eligibility verification (online/ calling)
  • Prior authorization with patients calling and doctor’s office follow up for relevant documentation that needed for the process is also done by us
  • Order Confirmation
  • Scheduling of the delivery
  • Claims management
  • Rejection management
  • Payment posting auto (with and without audit as well as manual)
  • Account receivable follow- up as well as management
  • Denial management 

So for a stress free prior authorization process, get in touch with our PriorAuth Online experts and experience a seamless operational along with a customized solution for revenue generation. We give you the ideal blend of master assets that can fill in as your dependable operational expansion. Influence the PriorAuth ONLINE advantage in prior authorization services. For more information and to know what difference our PriorAuth Online experts can bring to the table call us over a 'no commitment call'. We are just a call away!

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