Have Your Precertification Process managed by Experts
Some managed care programs, point of service plans, and Medicare and Medicaid require precertification’s for procedures such as hospital admissions, surgeries, and some outpatient procedures. Failure to obtain preauthorization for procedures mandated by the payer can result in huge financial losses to the provider.
We Prime Doc Billing as your prior-authorization company, can rest assured that all the procedures involved in the precertification’s process will be managed efficiently. Our dedicated prior-authorization specialists will work with your office to ensure that
- Your claims for treatments or services that require preauthorization are submitted promptly
- You have met all of the payer’s criteria before submitting a prior authorization request
We will ensure that precertification’s are submitted with the following
- The patient’s insurance and demographic details
- A verbal or written order from the referring physician
- Referral from the primary care physician to the physician ordering the exam, if needed
- Detailed diagnosis, detailed clinical indications, past medical history, and the reason for the requested exam
- Number of sessions or days of inpatient status expected for hospital stays and extended care facility stays
Benefits of Our Pre Certification Services
- Secure web-based portal for carrying through the process
- Reports on pre-certs completed and/or status updates
- Reduced paperwork and errors
- Reduced insurance write-offs and denials
- Precertification in fast turnaround time
- More time to focus on patient care
- 30% to 40% reduction in operational costs
