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Check If Needed

Before a medical procedure, doctors assess its necessity for your health and check insurance coverage.


Collect Information

Collect necessary information, such as medical records and test results, to justify the procedure's necessity.


Verify Insurance

We confirm insurance coverage, and if needed, obtain prior authorization before the procedure.


Ask for Permission

If necessary, they request permission from your insurance by providing proof of the procedure's necessity.


Insurance Review

The insurance reviews the request, deciding on permission based on necessity and coverage.


Approval or Denial

They can approve (say "yes") or deny (say "no") the request, providing reasons for denial if necessary.


Tell You and Schedule

The doctor informs you of permission; if granted, they schedule; if not, they explore alternatives or appeal.


Keep Records

They maintain documentation for their records, including papers and emails related to the process.



Post-procedure, they bill your insurance, using granted permission to ensure accurate payment processing.


Questions & Concerns

Patients and their families often have questions and concerns about their healthcare. Handling these well is important:

What's Prior Authorization in billing?

It's securing insurance pre-approval for specific medical treatments or services, ensuring coverage and efficient processes.

Why's it crucial in billing?

It's vital for ensuring coverage, reducing claim rejections, and minimizing operational delays in the revenue cycle.

How boosts billing efficiency?

It streamlines processes by obtaining necessary approvals in advance, contributing to enhanced overall billing efficiency.

Which services often need approval?

Services like surgeries, diagnostic tests, and medications may require prior authorization to confirm coverage.

Challenges in Prior Authorization?

Providers face challenges such as navigating complex documentation, managing varying approval timelines.

Improve Authorization workflow?

Providers improve workflow with tech, stay informed on payer guidelines, and establish communication for approvals.

We champion the BPO to achieve the extraordinary

Fostering a Culture of Innovation: By championing the BPO sector, we encourage and support innovative approaches that lead to extraordinary outcomes, ensuring continuous improvement and growth.

Elevating Performance Standards: Our commitment to championing the BPO industry involves setting and upholding high performance standards, driving excellence and surpassing expectations for extraordinary results.

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