Prior and Retro Authorization Services

Prior and Retro Authorization Services

The Importance of the Pre-Authorization Process

The pre-authorization process is vital for ensuring that a medical procedure is covered by a patient’s insurance. However, this process can be time-consuming and often lowers productivity and turnaround times for doctors and administrative staff. Specific medical procedures must be approved or pre-certified before being performed for the insurance company to cover them.

Managing pre-authorization is a challenging task for busy practices. NexaCare Solutions offers efficient insurance authorization services, ensuring that this process is handled effectively without consuming excessive time or resources. Our experienced staff streamlines the pre-authorization process, enhancing overall efficiency.

Prior and Retro

Why Outsource Prior Authorization Services?

Prior authorizations are among the most challenging tasks for a medical practice. This labor-intensive, difficult, and costly process consumes significant time and resources. Consequently, many healthcare systems and hospitals opt to outsource this work to experienced medical billing companies. Outsourcing prior authorizations to a specialized company can save time and money, allowing patients to receive timely treatment or diagnostics.

Benefits of Outsourcing Insurance Prior Authorization Services

Outsourcing companies handle various responsibilities, including:

Saving time and avoiding the hassles of dealing with payers.
Allowing employees to focus on their primary responsibilities.
Ensuring maximum reimbursement.

Advantages of Outsourcing Pre-Authorization to NexaCare Solutions

Outsourcing offers incredible advantages: it saves time and money, reduces the administrative burden, and lowers the risk of a medical records review that could potentially halt your revenue stream. By outsourcing pre-authorization tasks to NexaCare Solutions, you can rely on our experienced specialists to assist with your goals efficiently.

Prior and Retro

Comprehensive Pre-Authorization Services by NexaCare Solutions

NexaCare Solutions offers a thorough pre-authorization process from start to approval:
We manage the entire pre-authorization procedure, obtaining authorization from insurance companies for procedures and services that require prior approval.
If additional information is needed for a pre-authorization, we proactively contact the concerned doctor.
If a pre-authorization request is denied, we file an appeal whenever possible.
Our secure and HIPAA-compliant platform provides regular updates.
Our pre-authorization staff maintains compliance with up-to-date training.
A specialized pre-authorization team ensures fewer errors and a more streamlined billing system, improving your practice’s overall efficiency.

Specific Prior Authorization Services We Offer

Our pre-authorization services support hospitals, outpatient institutions, and physician practices in the following ways:
Managing the entire pre-authorization procedure.
Obtaining authorization from insurance companies for procedures and services requiring prior approval.
Monitoring for additional information needed for pre-certification from the physician.
Handling refusals and filing appeals when relevant.
Implementing quality control procedures, utilizing structured billing processes, and ensuring thorough prior authorizations to guarantee error-free billing.

By choosing NexaCare Solutions for your pre-authorization needs, you can ensure a more efficient and productive practice, enabling you to focus on delivering exceptional patient care while we handle the complexities of the pre-authorization process.

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+1 (929) 663-1565

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108 Oliver AVE, Valley Stream New York
11580, USA

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