Prior Authorization & Insurance Verification

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Optimize Your Authorization Process

AccurusBill ensures seamless prior authorization and insurance verification, reducing treatment delays and claim denials. Our proactive approach lets you focus on patient care while we handle the complexities of payer requirements.

Our Prior Authorization & Verification Process

Identifying Approval Needs & Verifying Coverage Up Front

Early Detection of Prior Auth Requirements

Challenge

Missing or late prior authorization requests often lead to treatment delays, unhappy patients, and potential claim denials.

How We Handle It

During scheduling or pre-visit confirmation, AccurusBill reviews each procedure or service against known payer rules. By flagging approval needs right away, we help you avoid last-minute surprises and keep your schedule running smoothly.

Accurate Insurance Verification

Challenge

Patients may arrive with outdated insurance info, or their plan might have restrictions that staff only discovers at the last minute.

How We Handle It

Our team verifies insurance details before the appointment date—checking eligibility, plan coverage, and any co-pay/deductible obligations. This front-end clarity helps reduce rejections and speeds up the path to reimbursement.

Prompt Submission of Prior Authorization Requests

Complete Documentation, Same-Day Submission

Challenge

Incomplete clinical evidence or missing diagnosis details can stall approvals, pushing back essential treatments.

How We Handle It

Once we confirm that a service requires prior authorization, we compile the necessary clinical data from your EHR (progress notes, imaging reports, etc.) and submit the request the same day whenever possible. Our goal is to provide payers with a clear, accurate narrative of medical necessity to minimize back-and-forth.

Customized Checklists & Payer Guidelines

Challenge

Each insurer can have unique forms or medical policy criteria. Submitting a generic request can lead to immediate denials or repeated clarifications.

How We Handle It

AccurusBill maintains checklists aligned with major payers, ensuring we include all required details (e.g., specific CPT codes, ICD-10 diagnoses, prior treatments tried) for each request. This thoroughness reduces re-submissions and shortens approval times.

Active Follow-Up & Escalation of Stalled Requests

Daily Status Tracking

Challenge

Payers can delay decisions by requesting additional documentation or simply moving slowly, leaving providers guessing about request status.

How We Handle It

Our team monitors all pending prior authorizations daily, checking payer portals or calling insurer reps to ensure no request sits idle. This vigilance lets us respond quickly if payers ask for more information.

Direct Communication with Payer Medical Directors

Challenge

When requests stall or get denied for questionable reasons, front-line payer reps can’t always expedite the process.

How We Handle It

If we see a request languishing or an unfounded denial, we escalate to higher-level payer contacts, including medical directors if necessary. By presenting clear clinical justification and referencing policy guidelines, we push for timely decisions so your patients receive treatments without further delay.

Detailed Documentation for Appeals

Challenge

Some prior authorizations end up denied despite best efforts, and appeals can be time-consuming.

How We Handle It

Should a request be denied, we prepare a structured appeal with the supporting medical evidence. Having tracked every step and payer communication, we’re able to resubmit quickly and advocate effectively for approval.

Ensuring Smooth Patient Experience & Reduced Administrative Burden

Advance Patient Notifications

Challenge

Patients sometimes discover coverage gaps or prior auth issues after arriving for an appointment, leading to confusion and rescheduling.

How We Handle It

By verifying insurance coverage and obtaining the necessary authorizations beforehand, we help your front-office staff inform patients of any potential out-of-pocket costs or steps needed—enhancing patient satisfaction.

Minimizing Treatment Delays

Challenge

Delayed authorizations can push procedures back by days or weeks, risking patient outcomes and clinic revenue.

How We Handle It

Our proactive approach—swift submission, daily follow-ups, and escalation—keeps approvals on track so you can proceed with treatments as scheduled.

Transparent Reporting & Communication

Challenge

Providers often don’t know which requests are still pending, or why certain authorizations take so long.

How We Handle It

AccurusBill updates you regularly—via quick summaries or weekly reports—highlighting each pending request’s status, next steps, and any payer communication. You remain informed without chasing payers yourself.

Why Choose AccurusBill for Prior Authorization & Insurance Verification?

Early Detection of Requirements

We identify approval needs right when appointments are set, preventing last-minute cancellations or denials.

Same-Day Submission

Our team gathers all clinical evidence and dispatches requests promptly, speeding up approvals.

Aggressive Follow-Up

We don’t let payer delays drag on. We check daily and escalate issues until you get a final decision.

Reduced Administrative Stress

By verifying insurance details and obtaining prior authorizations, we free your staff to focus on patient care.

Patient-Centered

Timely approvals mean fewer treatment postponements, better patient satisfaction, and a stable revenue flow.

Partner with AccurusBill for Seamless Authorizations

With AccurusBill’s Prior Authorization & Insurance Verification services, you gain a partner dedicated to eliminating delays and ensuring coverage. Our proactive process—early detection, prompt submissions, and relentless follow-up—keeps your treatments on schedule and your revenue secure, allowing you to prioritize patient care.

Ready to Eliminate Authorization Delays?

Partner with AccurusBill to streamline your process, verify coverage, and focus on patient care.

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