Prior authorization requirements for diagnostics and procedures are evaluated on a case-by-case basis. There are no streamlined requirements for prior authorization among the various insurance carriers, and each case must be processed individually.
For carriers requiring prior authorization, it may be obtained by phone, web portal, or other submission methods depending on carrier requirements. In any of these cases, the process is often confusing and time-consuming (in some instances, taking several weeks to obtain), and may include the submission of supporting medical records, letters of medical necessity, peer-to-peer reviews, and appeals. There are many moving parts that have to be completed before, during, and after the prior authorization process, and particular caution is taken to avoid a carrier denial.
The Pier 17 Authorizations Department is skilled at educating and guiding medical practices on the authorization process and obtaining fast approvals. Most importantly, our team is able to take over this critical step in the insurance claim processing cycle for your staff and make sure that all necessary pre-certifications and approvals are obtained before your patients walk through the door. If you’re looking for professional help, contact us today!
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