Pre-authorization, prior approval, or pre-certification--all these terms refer to obtaining prior approval from an insurance payer before a doctor provides services to a patient. The payer's confirmation that a treatment plan, medical device, or prescription medication is medically needed results in a number of authorizations that must be added to the claim.

Referrals are when a PCP refers a patient for consultations or services that they cannot provide. Most insurance companies will not pay for a specialist visit unless this is done. You must keep this referral for your patient on file to be able to submit a claim.

These steps are crucial in the revenue management cycle. Pre-authorizations and referrals can offer several benefits.

Only the amount of your current A/R that is recovered will be charged. A/R services are usually charged on a 50-50 basis up to $1,000,000 in current A/R. However, pricing can vary based on your A/R's age and situation. Please provide us with some basic information regarding your practice, including the current volume of A/R. We will contact you within 2 business days. You can also call our helpline at 000-000-0000