Pre-Authorization, Pre-Approval & Pre-Certification
Approvals Secured. Delays Prevented.
Prior authorization is one of the most time-consuming administrative burdens in healthcare. Every request carries its own payer rules, documentation requirements, portals and follow-up cadence — and every missed step delays care.
Authorization tracker
In progressMedical necessity documented
Request submitted to payer
Status tracked & followed up
Followed up on a defined cadence
Determination received
If denied
Appeal support begins immediately — no waiting for the next review cycle.
Key benefits
What this changes for your practice
Care proceeds on schedule
Active tracking and follow-up keep requests moving instead of sitting unattended in a payer queue.
Documentation that holds up
Medical necessity is documented clearly and consistently, strengthening both the initial request and any appeal.
Clinical time returned
Providers and clinical staff stop spending their day on payer portals and hold music.
What we handle
Everything included in pre-authorization
- Authorization requirement identification
- Documentation collection
- Submission and management
- Letters of Medical Necessity
- Approval tracking
- Follow-up until determination
- Denial review
- Appeals and resubmissions
- Peer-to-peer coordination
- Approval and denial updates to your team
In detail
The full scope, broken down
Payers covered
- Health Insurance
- MVA
- No-Fault
- PIP
- Workers' Compensation
- Commercial insurance
- Employer-sponsored insurance
- Medicare
- Medicaid
- Managed care
Surgery
- Surgical procedures
- Outpatient surgery
- Inpatient procedures
- Ambulatory surgery
- Orthopedic surgery
- Spine procedures
- Pain-management procedures
- Specialty-specific surgery
PT / OT / CH / AC
- Physical Therapy
- Occupational Therapy
- Chiropractic
- Acupuncture
- Rehabilitation
- Therapy evaluations
- Treatment plans
- Additional visits
- Continued care
Diagnostic Imaging
- MRI
- CT
- X-ray
- Ultrasound
- Diagnostic imaging
- Advanced diagnostic studies
Pain Management
- Injections
- Epidural injections
- Joint injections
- Trigger-point injections
- Nerve blocks
- Facet injections
Electrodiagnostic
- EMG
- NCS
- Nerve conduction studies
How it works
The workflow, step by step
Requirement identification
We confirm whether authorization is required for the planned service and identify the payer's specific criteria.
Documentation & submission
The request is compiled with supporting clinical documentation and submitted through the payer's required channel.
Tracking & follow-up
Status is monitored on a defined cadence, with proactive follow-up rather than waiting for the payer to respond.
Determination, appeal & peer-to-peer
Approvals are relayed immediately; denials move into review, appeals, resubmission and peer-to-peer coordination.
An authorization that stalls does not just delay reimbursement — it delays care. Consistent ownership of submission, tracking and appeals keeps the schedule intact and prevents services being rendered against an approval that never actually arrived.
Connected workflow
Departments this one works with
Insurance Verification
Eligibility and benefit verification across every payer type — coverage, deductibles, co-pays, co-insurance, out-of-pocket maximums and policy limitations, confirmed before the visit.
Learn moreMedical Records Management
Retrieval, tracking, organisation and distribution of records — the information bridge that keeps billing, authorization, clinical and legal teams working from the same file.
Learn morePre-Encounter Review & Patient Confirmation
Proactive pre-appointment contact that confirms the visit and resolves demographic, insurance, authorization, referral and documentation discrepancies before the patient arrives.
Learn more
Ready to hand off pre-authorization?
Tell us about your practice and current workflow. We'll outline what support would look like and which engagement model fits.