Precertification Authorizations

The Phoenix team of Insurance Specialists have many years’ experience in obtaining precert authorizations for radiological tests as well as surgeries, and provide a full cycle process to insure that denials are a rare occurrence once Revenue Cycle submits the bill for the procedure. Our Specialists retrieve clinical data directly from the EMR, call the insurance company, schedule appointments, notify patients, fax the forms, and do insurance verification prior to test date.

Because Phoenix works so rapidly, within hours of a request being generated, the patients are contacted with their Authorization number and appointment info that day, eliminating the success of the Insurance companies to invoke their Member Scheduling policy of recommending another facility for the test, and in essence, stealing away the patient.

With an authorization rate in the very high 96-98th percentile, our facilities have seen a dramatic drop in their high dollar denials, sometimes, three to six months after the test has already been performed. The physicians love that Phoenix relieves their staff of the time consuming processes of dealing with insurance and scheduling, and start referring their patients to the Facility Radiology service, keeping those high dollars right there at the Facility. All the machines are utilized all day long, and revenue is significantly increased.

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