Prior authorization support
An approval you cannot see is an approval you cannot use.
Authorization failures rarely happen at submission. They happen when units run out, a date range lapses, a renewal is missed, or the approval is filed somewhere the scheduling and billing teams never look. We keep authorization detail where the whole workflow can act on it.
Track the service, provider, location, dates, units, status, and next action—not just an approval number.
Who it fits
Practices this service is built for
- Behavioral health and addiction medicine practices with recurring visit authorizations
- Practices delivering services with unit, frequency, or date-range limits
- Teams where scheduling and billing use different authorization records
- Practices seeing denials for missing or expired authorization
What is included
- Benefit and requirement verification by payer and service
- Authorization submission with supporting documentation
- Status tracking and documented payer follow-up
- Unit, date-range, and expiration monitoring
- Renewal and continuation requests
- Escalation and reconsideration support
What you still own
- Clinical necessity determination and supporting documentation
- Scheduling decisions and service delivery
- Peer-to-peer participation when a payer requires it
- Final decisions about proceeding without authorization
Deliverables & reporting cadence
- Authorization control view: service, provider, dates, units, status
- Upcoming expiration and renewal list
- Pending-request tracker with last payer contact
- Monthly authorization-related denial summary
Explicitly out of scope
- Any guarantee of authorization approval or coverage
- Clinical decision-making or medical necessity determination
- Retroactive authorization where payer policy does not permit it
- Direct patient benefit counseling
How it works
A four-step workflow
- 01
Requirement map
Determine which services and payers require authorization and what evidence is needed.
- 02
Submit
File complete requests with documentation and record the payer reference.
- 03
Track
Monitor status, units, and dates with documented follow-up.
- 04
Renew
Trigger renewals before expiration and report authorization-driven denials.
Questions
Prior Authorization FAQ
Next step
Start with a Revenue Readiness Review.
We map providers, payers, services, systems, current A/R, authorizations, and credentialing status before recommending scope.
Book a Revenue Readiness ReviewPlease note: Do not include patient names, dates of birth, member IDs, diagnoses, records, claim documents, or other PHI.