Prior Authorization / Pre-Certification Management Services

Why Outsource with Prime Care Health Solutions

Prime Care Health Solutions understands that outsourcing your business to us is a major decision and we want to help you make the best decision possible for your business. That is why we have solution managers who can help you to make that difficult decision by going over the different aspects of your business and helping you to find the right solution.

Our Strategy

Our experienced staff works in partnership with physician offices and insurance payers, ensuring comprehensive management of your prior authorization/ pre-certification cases for hospitals, outpatient facilities, physician offices and many more. Please contact us for a no obligation free consultation by one of our solutions manager. We want you to be satisfied in knowing that Prime Care Health Solutions will deliver the best service and most competitive pricing available.

Our Goals

Our aim is to liberate healthcare personnel from the acute demands of prior authorization, and find more time and peace of mind to concentrate on actual patient care. We accomplish this by consistently delivering the best support to our clients for getting prior authorizations/pre-certification completed quickly, accurately and cost-effectively.

Our Experience

We help healthcare practices of all shapes and sizes cut cost, boost revenue and earn massive collections from insurance claims. We also work with Insurance payers in adjudicating claims. Our teams of specialist have years of experience backed with superior knowledge of the industry that helps get claims reviewed and approved sooner and faster!

Outsourcing comes with incredible advantages

  • SAVE TIME & MONEY:Our service eliminates much of the burden on your administrative staff allowing you to better utilize staff resources for patient care
  • PROVEN EXPERTISE: Our staff has years of experience successfully handling prior authorization to give you the best service results.
  • FAST RESOLUTION: Our prior authorization experts are well-versed in the ins and outs of the process.  The result? Faster prior authorization resolutions
  • UNIQUE INSIGHT: Our years of experience working with major Insurance payers, along with our years of experience in adjudicating claims, has given us a deep understanding of the prior authorization process. This is clearly reflected in our high success rate with prior-authorization/ pre-certification cases.
  • FLEXIBILITY: We don’t have binding contracts. Feel free to cancel anytime. You can also work in small bursts, or opt for bulk requests - short-term or long-term.
  • HIPAA COMPLIANCE: Our operations are 100% HIPAA compliant
  • SECURE TRANSACTIONS: Every piece of data exchanged between Prime Care Health Solutions and our clients are secure.

Additional Benefit of Outsourcing PA/Pre-Cert with Prime Care Health Solutions

  • Focus on Patients, and Not Paperwork.

    When fewer of your internal resources are focused on medical prior authorizations, this frees you to spend more time doing what you and your staff do best – delivering exceptional patient experiences.

  • Save More Money

    Outsourcing medical prior authorizations with Prime Care Health Solutions can actually save your practice money. Less overhead, less ongoing training, and fewer resources tied up in administrative processes. We offer quality affordable service that will help reduce billing errors and improve patient outcomes. Our clients pay only for the number of authorizations needed at no minimum order volume.

  • Minimize Paperwork

    Prime Care Health Solutions securely and electronically handles PA requests, eliminating the need for hand-written forms or calls to the plan. PA/Pre-Cert requests are also accepted via website through online PA/Pre-Cert request form or via e-fax, eliminating the need for bulky paper-based orders or waiting for days, if not weeks.

  • Improve Patient Experience

    Lessened administrative burdens mean more time to greet patients when they walk through the door or answer their questions on the phone — and delivering the care your patients know and trust.

  • Reduce Billing Errors

    Prime Care Health Solutions prior authorization specialists are trained and equipped with the knowledge that they need to get the right authorizations for your practice, helping to reduce rejected claims and increase reimbursements.

  • Take Back Time

    Fewer patients showing up for appointments without authorizations means a more manageable schedule, improved access to timely care, and better–utilized staff hours.

  • Ensure Billing Compliance

    It’s a full-time job to keep up with the changes in Medicare, Medicaid, and third-party payers. But Prime Care Health Solutions has made it our job to stay on top of those changes for you, so that you remain in compliance without worry.

  • Grow the Bottom Line

    Efficient and accurate prior authorization processes do more than reduce costs; they improve payment cycles and reimbursements, all resulting in a healthier bottom line.

  • Better Accuracy

    Experience the highest PA/Pre-Cert processing accuracy as we handle all your PA requests with professional care and speed. We can increase the number of successful authorizations you receive.

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