Prior Authorization
Prior Authorization Services
At Prime Edge Medical Billing we simplify the complicated and time consuming prior authorization process so your practice can focus on delivering exceptional care. Prior authorizations are essential for many procedures medications imaging studies and specialty treatments but they are also one of the biggest causes of delays and claim denials.
Our team handles every step of the authorization process with accuracy speed and payer specific expertise ensuring your services are approved before the patient arrives.
Why Prior Authorization Matters
Prior authorization plays a critical role in protecting your revenue and preventing claim rejections. Without proper approval practices face:
Claim Denials
when services are not pre approved
Treatment Delays
that impact patient care
Longer Reimbursement Cycles
due to missing authorization numbers
Lost Revenue
when insurance refuses to pay after a service is already performed
With Prime Edge Medical Billing you never have to chase approvals or worry about missing requirements. We take care of everything from documentation to payer communication.
Our Prior Authorization Process
Verification of Requirements
We check directly with the patient's insurance plan to determine whether the service procedure or medication requires authorization.
Gathering All Required Documentation
Our team collects charts clinical notes imaging reports and any supporting documents needed for approval.
Submission to Insurance Payers
We complete forms gather payer specific data and submit the request accurately to avoid delays or rejections.
Daily Follow Up With Payers
We track each authorization request through regular phone calls portal checks and email communication until approval is confirmed.
Notification to Your Practice
Once approved we provide the authorization number validity dates and any special instructions so your team can proceed with confidence.
Authorization Renewal and Extensions
If a service requires extended treatment our team manages renewals and revised approvals to keep your claims protected.
Why Choose Prime Edge Medical Billing for Prior Authorization
Fast Turnaround Times
We reduce approval wait times significantly through proactive follow up and accurate submissions.
Specialty Focused Support
We manage authorizations for primary care specialty care surgeries mental health radiology therapy medications and more.
Decrease in Claim Denials
Our accuracy and payer knowledge drastically reduce denials related to missing or incorrect authorizations.
Improved Patient Experience
Patients receive timely care without unnecessary delays or surprise costs.
Seamless Integration
Our team coordinates with your providers EHR staff and billing department to ensure a smooth and organized process.
Insurance Specific Expertise
We handle authorizations for Medicare Medicaid commercial payers specialty insurers and pharmacy benefit managers.
Types of Prior Authorizations We Handle
Everything is managed with precision confidentiality and compliance.
Diagnostic Tests
MRI, CT scans, and ultrasound
Procedures
Outpatient and inpatient procedures
Medical Equipment
Durable medical equipment approvals
Medications
Prescription and specialty medication authorizations
Behavioral Health
Behavioral health and therapy services
Surgical Procedures
Surgical procedures
Therapy Services
Physical therapy, occupational therapy, and speech therapy
Let Prime Edge Handle Prior Authorizations So You Don't Have To
Avoid delays denials and lost revenue. With our dedicated authorization experts your practice can run smoothly while we secure approvals quickly and accurately.