Prior Authorizations
Many medical treatments for patients must be permitted or certified prior to being performed to ensure that they are covered by the respective insurance company. This process is very cumbersome and laborious for Medical Practitioners, Hospitals and Patients too. If this task is made easy by an expert prior authorization service provider, then all the parties can focus on more important tasks that need their immediate attention. Elite is here to help you with you with this process.
Rx-Solution's Prior Authorization services assist Doctors, Hospitals and outpatient facilities in:
- Obtaining Prior authorization for procedures and services that need pre-approvals.
- Saving time and simplifying the complications involved in the process.
- Claiming thoroughgoing reimbursement on the treatments needed.
- Some of the procedures and treatments like hospital admissions, surgeries/operations and some outpatient programs need pre-certifications. If the prior authorization for these procedures is not authorized by the payer, then the providers can incur great financial losses.
As your Service Provider we will ensure that:
- Your claims for treatments or services that may need prior authorization are completed successfully.
- You have completed all that is needed to match the payer’s criteria before a prior authorization request is submitted at any hospital.
The pre-certifications are monitored and submitted through us with:
- The patient’s insurance and demographic information.
- An oral or transcribed order from the Doctor who is treating.
- A detailed file with the information of the diagnosis carried out, reports of clinical indications, previous medical history and the causes for the prescribed medical examinations.
- The information of the total number of days the patient is expected to stay in hospital.
- Ensuring that you can focus fully on your patient care as we will take care of mobilizing the reimbursement process for you to receive it on time.