Authorizations

Billed Right can help streamline your workflow by handling your authorization/referrals.
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Authorizations/Referrals

Pre-authorization, prior approval, or pre-certification, all of these terms mean the same thing – obtaining prior approval from an insurance (payer) before a doctor provides services to a patient.  This confirmation by the payer that a procedure, treatment plan, medical equipment, or prescription drug is medically necessary provides an authorization number that has to be included on the claim when submitted.

A referral, on the other hand, is when a primary care physician (PCP) recommends a patient to a specialist for consultation or healthcare services they are unable to provide. Many insurance companies require this step before agreeing to pay for a visit to a specialist. To file a successful claim, you have to make sure you have this referral on file for your patients.

These steps in the revenue cycle management are critical. Obtaining pre-authorizations or ensuring you have a referral can provide several advantages:

  • Accountability and cost containment
  • Reduction of denials and enhanced collections
  • Reduction in write-offs
  • Increase in revenue

The process for obtaining prior authorizations and referrals can be done in many ways such as:

  • Phone calls
  • Online forms
  • Faxes sent through PMS

All of these take time and add an administrative burden on your staff! Time that could be better spent ensuring the quality of patient care is delivered and maximized. Also, your staff needs to be aware of a variety of different payer’s guidelines, which continually change. Staying ahead of all of these changes is time-consuming as well.

Billed Right helps save you time and reduce your denials!

Authorization medical billing services

 

 

Understanding all of the ins and outs of obtaining pre-authorizations and referrals is important in avoiding lost revenue and negatively impacting your practice financially. Billed Right has the expertise to help you manage what can sometimes be a very complex process.

To learn more about how Billed Right can help you with authorizations and referrals contact us today!

Our Expertise

Outsourcing Prior-Authorization/Referrals is the Best Option

At Billed Right our Authorization & Referral service provides doctors with the additional resources to obtain necessary pre-authorizations/referrals and ensure claims are submitted with the required information for each payer, thus offering a more optimized workflow saving you time and money.

With our authorization/referral service you can expect:

  • A virtual prior authorization resource
  • Submission of request within 12-24 hours
  • Track record of the authorization and referral steps completed
  • Notification if a peer-to-peer review is requested
  • Work done through Practice Management System
  • Communication with staff on approvals and denials of auth and referrals

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TESTIMONIAL

What clients say

Account Managers are always readily available to help me. I appreciate their efforts daily! Our AM is a true gem and gift to any client account she manages. Her knowledge and suggestions aid me and my clinic in many ways. I would never have been able to execute a few items without her help. I was not in my current role before they chose to use Billed Right, however, I do see reports that show substantial increases in Revenue for my company. I appreciate the transparency of reporting, coding, and claims with the team and within the system. I would highly recommend Billed Right to others. In fact, at the most recent Meditab conference, Billed Right’s contact information was given freely with praise to several small business owners in need of financial assistance.

Practice Administrator of Urgent Care, TN

Billed Right has depth that similar service organizations do not. There is not a one or two-person team that handles everything. It is an organization that as a team understands our account. We have senior leadership, on the ground leadership and day to day team members that know our account. That is not easy to replace and certainly, at our size, not something we could bring internally without a significant commitment to infrastructure. While we cannot speak to how they may align with a specific set of needs…they are a professional organization with solid tools. Ultimately you will choose an outside billing partner for the simple reason of increasing collections. This will happen with Billed Right…but to us…as much as increasing our cash flow is their team of professionals. I like them, respect the contribution they make to our company and openly offer my personal recommendation.

CEO, Pain Management, CA

I have been associated with Billed Right for the past two years since I started my practice. Billed Right have been incredibly helpful in assisting my practice with initial credentialing, providing prompt responses to all my requests and excellent service to address my concerns. I am very satisfied with their timely insurance billing, collections, low AR, and patient accounts management. My Account Manager meets with me regularly to review and discuss management reports and address my questions in a professional and promptly manner. I am very satisfied and could not ask for better service. For these reasons I highly recommend Billed Right to anyone looking for a reliable practice management service.

Psychiatry Provider, FL

Billed Right is very knowledgeable in every aspect of business. When our Dr. First acquired the practice, it was a huge mess because one provider was leaving, and one was coming in but Billed Right stuck in there with patience and loyalty. Account Managers are top notch when it comes to every aspect of the business and make sure that you are comfortable in what they teach you. Staff members are very competent and have patience of saints to put up with credentialing and enrollment processes. Staff are polite and know what they are doing and go out of their way to help in every situation. I want to thank each one of the teams. Patient call rep is awesome and is also top notch in the field.

Nephrology Office Manager, FL

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Our Brochure

Authorization-Brochure