Prior-Authorizations
What is it?
RelateCare’s prior authorization process is automated, integrated, and as complete as possible in order to support organizations in qualifying for payment before they can deliver the ordered service their patients need — eliminating large amounts of work from your organization and into the hands of trained experts who can submit requests and documentation to payers, help you understand why a denial occurs, and work with the payer to approve your request in a timely and efficient manner.
How does it work?
RelateCare provides a team of expertly trained prior authorization representatives who work around the clock utilizing online portals, faxes, incoming and outgoing phone calls to submit and follow up on authorizations for all specialties, clinic visits, diagnostic/imaging testing, inpatient/outpatient surgeries, and primary care physician referrals.
Why do you need it?
Prior authorizations and pre-certification’s are necessary and unavoidable to ensure patients are covered for the care they need. The service often involves dedicated staff members spending significant time on the phone with payors in order to verify whether or not authorization is even required. When carried in-house, these services cost your organization a substantial amount of time and money.