Precertification Authorizations

The Phoenix team of Insurance Specialists is responsible for obtaining half a million precerts a year for multi-department medical centers, radiology centers, and specialty standalone facilities. Phoenix provides a full cycle process to ensure that denials are a rare occurrence 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 the test date.

Our clients include the top-rated Orthopedic Hospital in the Nation, as well as the largest hospital system in the Northeast, with 27 hospitals and specialty clinics, encompassing all types of testing, and a top-rated Cardiology Center from a major teaching university hospital sending thousands of echos and stress tests per year. Phoenix provides services for injections and surgical authorizations, medications and DMEs, as well as the major radiology tests.

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 their in-house facility, keeping those high dollars right there.

Because Phoenix works so rapidly, within hours of a request being generated, the tests can be scheduled with confidence that the determination will be done prior to the appointment, eliminating cancellations, lost revenue and upset patients. This process results in a very low percentage of unused slots, and increased revenue daily for the facility.

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