Losing money often happens when authorization isn’t obtained before a procedure. Missing pre-authorization, prior authorization, pre-certification, and notification are common reasons for denied payments. Some procedures need these approvals, and not having them can risk payment.
Authorization means getting permission from the insurance company for a medical service. Doctors or billing companies must contact the insurer beforehand to get a special number for payment.
Quantum Medical Services knows the Authorization process well. We handle it carefully because it takes time and effort. Our specialists check eligibility, get insurance benefits, and manage all paperwork for approvals.
We make sure everything is done correctly and keep everyone informed about changes that might affect financial growth.
Getting insurance approval before a medical procedure makes sure you have coverage, but it can take a lot of time and be frustrating for doctors and staff. Some procedures need to be approved by the insurance company first. Handling this process is hard for busy medical practices. Quantum Medical Services can help with efficient prior-authorization services, saving time and resources.
Make sure the patient’s insurance will pay for the treatment and that the patient is allowed to get it under their plan.
Gather all the important medical records and use the correct codes for the illness and the treatment. Fill out the pre-authorization forms carefully.
Send all the gathered paperwork to the insurance company and make sure they receive it. Give any extra information if they ask for it.
Keep an eye on the status of the request and stay in touch with the insurance company to make sure they process it on time.
Get the decision from the insurance company, whether they approve or deny the request. Update the patient’s records accordingly. If approved, go ahead with the treatment, then send the claim after the treatment is done to make sure the payment is received and properly handled.
Improving prior authorization is very important in healthcare. It helps doctors check if certain medical treatments and medicines are really needed before giving them. This process also helps save money and stops doctors from giving too much medicine. When doctors get approval for treatments and medicines ahead of time, they can make sure the service is necessary and avoid repeating services if the patient sees another specialist.
Our credentialing services save you time by taking over time-consuming manual tasks. This lets your team focus on more important and impactful activities.
We handle all the tedious paperwork and endless applications, giving your staff the freedom to engage in tasks that drive your practice forward and help it grow.
We make the process of credentialing smooth, easing the burden of insurance inquiries and cutting down lost-profit risks. This guarantees you stay on track, improving your income.
Improve patient referrals and expand your practice with our efficient credentialing process, helping your practice thrive and attract more patients.
Our swift provider credentialing services make sure that you receive payments sooner, improving your cash flow and financial stability.
Get full assistance, from collecting information to sending it out, tracking, and connecting through emails and faxes. We manage the whole operation for you.
Our pre-authorization services help hospitals, clinics, and doctors in these ways:
We strongly suggest using quality control, getting prior authorizations, and having structured billing processes to make sure billing is accurate and without errors.
Getting approval for medical procedures can be tough. Right diagnosis and codes are important. Proper coding before treatment helps get quick approval, but its hard work for coders.
Sometimes, doctors plan and get approval for procedures, but the patient's health might need different procedures during treatment. If these new ones aren't approved, payment might be denied. It's better to get approval for all possible treatments. There's no problem if an approved procedure isn't done.
In emergencies, treatment starts right away without approval, often during accidents or sudden sickness at night or on weekends. Doctors should contact the insurance company quickly to get approval.
As a top provider of prior authorization services, we help healthcare providers make their billing process easier.
We carefully check each patient's insurance to make sure the treatment is covered, reducing mistakes and denials.
We use advanced methods to make the authorization process smooth and quick, speeding up the whole process.
Our experts know the rules and insurance processes well, making sure claims are settled easily and correctly, with a 98% success rate on the first try.
Our skilled coders use the right codes for authorization documents, preventing delays and denials.
We keep track of all authorization requests to avoid communication gaps, make sure fast approvals, and smooth claim settlements. We also follow up with Medicare teams regularly to prevent delays.
Prior-authorization is when you get permission from your insurance company before having a medical service to make sure they will pay for it.
It’s important because it helps make sure your insurance will pay for the medical service and stops them from saying no to the payment.
Quantum Medical Services helps by doing the whole prior-authorization process for you. We check if your insurance will pay, fill out and send the needed forms, and keep track of whether the insurance says yes or no.
