Prior Authorization
Streamlined Approval for Essential Patient Care
At Healthcare Partners Consulting & Medical Billing, LLC,
Our Prior Authorization service simplifies the process of obtaining insurer approvals for medications, tests, procedures, and durable medical equipment. This ensures timely treatment, reduces patient frustration, and protects your practice from denials and delays.
Why Prior Authorization Matters
Avoids treatment delays: No more surprises at the point of service
Protects practice revenue: Reduces denials and payment write‑offs
Improves patient experience: Ensures transparency and trust
Streamlines operations: Lowers administrative burden and rescues your team from piecemeal payer communication
Benefits to Your Practice
Faster approvals: Reduce delays in patient care delivery
Reduced denials: Complete, well-supported submissions increase approval rates
Time savings: We manage documentation, submission, and follow-up
Enhanced patient communication: Update clients on status and expected next steps
What We Handle
Our team manages all elements required for prior authorizations, including:
Submissions for medications, imaging studies, referrals, procedures, and durable equipment
Collection and review of clinical documentation to support medical necessity
Coordination between providers, payers, and pharmacies/medical suppliers
Electronic and phone follow‑ups to monitor authorization status
Appeals support for denied or partially approved requests
How We Work
Identify Needs – Your team flags services or products requiring prior authorization
Gather Documentation – We collect notes, labs, imaging, prescriptions, and clinical rationale
Submit Request – We file via electronic portal or phone, followed by immediate tracking
Follow‑Up – We proactively contact payers until a determination is reached
Respond to Denials – We assist with appeals or next steps if authorization is not granted
Why Choose Healthcare Partners
Expertise in behavioral health and specialty care
We understand payer-specific criteria
Robust tracking systems
Real-time monitoring of submission statuses
Effective payer communication
Dedicated follow-up to ensure timely decisions
Compliance-focused workflows
HIPAA-secure handling and clinical documentation best practices
Ready to Ensure Timely Care?
Our prior authorization services can be part of a comprehensive Medical billing package or engaged independently. We offer:
Flexible engagement—case-by-case or full-time support
Transparent pricing—per submission or publisher-based packages
Seamless integration into your workflows and EHR systems
Contact us today for a free prior authorization audit, and learn how we can reduce delays, streamline insurance approvals, and improve patient satisfaction.
Healthcare Partners Consulting & Medical Billing, LLC
Clearing the way for care — by removing administrative obstacles before they reach your door.
Frequently Asked Questions
What is prior authorization, and why is it necessary?
Prior authorization is the process by which insurance payers review and approve certain services, medications, or procedures before they are provided, to ensure they are medically necessary. Without prior authorization, the insurer may deny coverage, leaving your practice—and potentially your patient—responsible for the full cost. Securing prior authorization protects your revenue and ensures compliance with payer policies.
Which services usually need prior authorization?
Prior authorization is commonly required for:
Specialty medications (especially injectables or high-cost drugs)
Imaging studies (e.g., MRI, CT scans)
Out-of-network referrals
Psychological or psychiatric testing
Intensive outpatient or partial hospitalization programs (IOP/PHP)
Durable medical equipment (DME)
Repetitive or high-frequency services (e.g., therapy over a certain number of sessions)
Each payer has its own list, and we stay up to date to avoid missteps.
How long does the prior authorization process take?
The process typically takes 3 to 10 business days, depending on the payer, type of service, and whether the submission was electronic or manual. Urgent or expedited requests may be processed within 24–72 hours. We actively follow up with payers to minimize delays and keep your team updated.
What happens if a prior authorization request is denied?
If a request is denied, we assist in reviewing the denial reason, gathering any missing documentation, and filing an appeal or peer-to-peer review, depending on payer policy. We work closely with your clinical team to strengthen the case and resubmit promptly when appropriate.
How does Healthcare Partners assist with prior authorizations?
We manage the entire process—from collecting clinical documentation to submission, follow-up, and resolution. Our team knows the specific authorization requirements for behavioral and mental health services, and we use payer-specific portals and contacts to ensure timely and accurate processing.
Can prior authorization requirements delay patient care?
Yes, if not handled efficiently. Delays in obtaining authorization can postpone treatment or medication delivery, frustrating both providers and patients. That’s why we take a proactive approach, submitting requests early and following up frequently. Our goal is to keep care moving forward without interruption.