Prior-Authorization Services

Don’t let prior authorizations delay patient care. Our experts ensure timely approvals.

Expert Prior Authorization Management for Maximum Reimbursement

Obtaining prior authorization is an intricate process and incurs considerable time in administrative workflows that greatly contributed to the revenue cycle of a healthcare practice. This process entails getting authorization from insurance payers in advance before certain medical services, treatments, or drugs are administered. Given the dynamics of today’s payer environment and the ever-increasing documentation demands, managing prior authorizations can be highly challenging when conducted in-house.
That is why at Philadelphia Medical Billing Services, we take this stress and make it our responsibility to ensure that all prior authorizations are completed on your behalf. Our focus is on timely submission of claims, clear payer relations, and proper management of appeals so as to increase your claim success and your profitability.

Comprehensive Prior Authorization Services for Healthcare Specialists

At Philadelphia Medical Billing Services, we provide a package of services aimed to optimize prior authorization processes and increase your claim acceptance rates.

Deep Dive Payer Expertise

The process of obtaining prior authorization involves comparison of different entities, their standards, and technological platforms. Our team is familiar with the key commercial, Medicare, Medicaid, and MC requirements for authorizations

Expedited Prior Authorization Processing

Our dedicated prior authorization team provides support and uses modern technology and efficient processes to ensure the fast track of the authorization process.

Comprehensive Clinical Documentation Support

Prior authorization can only be successful if strong clinical documentation is in place. Our specialists work in strict coordination with the healthcare providers

Real-Time Visibility and Communication

For smooth processing of prior authorization, adequate communication is required. This way, you will be able to monitor the authorization status and be prepared for possible problems in due time.

Aggressive Appeals Management

Some denials are annoying and may take a lot of the healthcare worker’s time. Our dedicated appeal lawyers are always ready to commence the fight against prejudices and unjustified rejection.

Proactive Denial Prevention Strategies

It is much more effective to prevent denials from occurring rather than trying to deal with them once they happen. To find out the possible causes, our team produces detailed analysis of the denial trends of different sectors.

Data-Driven Prior Authorization Optimization

Information is the lifeblood of the decision-making process for constant improvement. It is worth mentioning that nowadays we apply innovative methods for monitoring authorization rates, analyzing potential opportunities, and uncovering inefficiencies.

Medical Billing Services

Our certified professional medical billers offer end-to-end billing services. Their responsibilities include handling patient check-in and check-outs, charge entries,

Coding Services

Medical coding team of our company uses ICD-10-CM, ICD-10-PCS, CPT, HCPCS coding sets. We follow AAPC and AMA coding guidelines to offer maximum compliance with regulations.

Provider Credentialing Services

Our credentialing specialist helps in unlocking privileges related to in-network enrollment. We assist providers in accelerating reimbursement and increasing revenue and patients at their practice.

Payment Posting Services

Proactive EOB (explanation of benefits) and ERA (electronic remittance advice) results in better collection on insurance claims. Our billing managers perform these difficult tasks nicely without making a single mistake.

Denial Management

Injury claims are costly and unpaid ones result in financial loss or bad debts. To tackle such losses, our team actively engages with payers and patients to keep the ratio of such cases to zero or at least minimum.

Insurance Verification Services

Our dedicated team has gained expertise in ensuring minimum disruption to cash flow to your practice. We automate the entire process of insurance eligibility verifications, providing quick results in claim rejections.

AR Management & Followup

Accounts receivables are a thorn in the flesh for all medical practices in the US. They result in revenue leakages and require a permanent solution rather than a short term.

Compliance with Health Laws

Following federal and state health laws ensures compliance with regulations. Being an industry’s leading medical billing company in Philadelphia, we help healthcare facilities meet these targets.

Reporting & Analytics

Primary care physicians, surgeons and family practice providers dealing with personal injury cases are provided detailed analytic reports by our team.

Prior & Retro Authorization

Billing staff of Philadelphia medical billing company gets prior authorization from insurance companies to avoid delays in treatment leading to better patient retention.

Benefits of Outsourcing Your Prior Authorization Services to Philadelphia Medical Billing Services

Improve prior authorization approval rates up to 25% by accumulating payer information and refining documentation submission.

Prevent claim denials and rejections through the implementation of proactive denial prevention strategies by 20%.

Improve claim payment cycle by 15% due to fast processing time and organization of report dissemination.

Regain missed revenues by 10% in appeals management and claim recovery with a stringent approach.

Reduce staff time commitment to prior authorization by at least 25% and direct them to spend their time on more patient related issues.

Reduce patient waiting and treatment time by 15% and, hence, increase patient satisfaction.

Improve your practice productivity by up to 20% with best practice guidance and improved workflow.

Reduce financial risks by 15% through effective compliance and risk management.

We Handle Prior Authorizations for Major Insurers

United Healthcare Prior Authorization:

 We optimize prior authorization for United Healthcare to enhance the likelihood of approval within the shortest time.

Aetna Prior Authorization:

Our expertise in Aetna prior authorization requirements helps maximize your claim reimbursements.

Medicare Prior Authorization:

Our major focus is Medicaid prior authorization and we are conversant with each state’s requirements.

Molina Prior Authorization:

We are knowledgeable about Molina Healthcare’s prior authorization process to ensure quick processing of approvals.

Accelerate Your Revenue Cycle with Expert Prior Authorization Services

Do not let prior authorization act as the brakes to your practice’s progress. Get in touch with us now and talk to our team to discover how we can assist you to enhance your revenue cycle and patients’ satisfaction.

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