Prior Authorization Services
Prior authorizations delay care and cause denials when they are missed. We check requirements, submit requests, follow up with payers and track every approval so your patients are treated on time and your claims get paid.
Stop Losing Revenue to Missing Authorizations
A missing or expired authorization is one of the hardest denials to overturn — many payers will not pay even when the service was medically necessary. Meanwhile your staff spend hours on hold and on payer portals instead of with patients.
AccMed RCM takes over the authorization workload. We check requirements as soon as a service is ordered, submit complete requests with the right clinical documentation and follow up until there is a decision.
What we handle
- Authorization requirement checks by payer and CPT code
- Complete request packets with clinical notes and diagnosis codes
- Submission by payer portal, fax or phone
- Daily follow-up on pending requests
- Tracking of approved units, visit counts and expiration dates
- Peer-to-peer scheduling and appeals for denied requests
How We Manage Prior Authorizations
Check
Confirm whether the payer and plan require authorization for the ordered service.
Prepare
Collect clinical notes, diagnosis and procedure codes the payer needs.
Submit & follow up
Submit and follow up daily until approval or denial.
Track
Record approval details and alert you before authorizations expire.
Related Services
Prior Authorization: Common Questions
What does a prior authorization service include?
We check whether a service needs prior authorization for the patient’s plan, gather the clinical notes the payer asks for, submit the request through the payer portal, fax or phone, follow up until a decision is made, and record the authorization number, approved units and dates in your system.
Which services usually need prior authorization?
Advanced imaging (MRI, CT, PET, nuclear studies), many surgeries and procedures, specialty drugs and infusions, durable medical equipment, sleep studies, therapy beyond a visit limit and some behavioral health services. Requirements vary by payer and plan.
How long does a prior authorization take?
Simple requests can be approved the same day through a payer portal; others take several business days or longer if the payer asks for more records. Urgent requests have faster review timelines. Starting early is the best protection.
What happens if a prior authorization is denied?
We review the denial reason, request a peer-to-peer review for your provider if the payer offers one, and prepare an appeal with supporting documentation when the service is medically necessary.
Can you handle authorizations for one specialty only?
Yes. Many practices use us only for imaging, procedure or therapy authorizations while keeping the rest of billing in-house.
Hand Off Your Prior Authorization Workload
Tell us which services and payers cause the most delays, and we will show you how we would handle them.