Services
Prior Authorization Services
Overview
Lack of prior authorization is consistently a top driver of denials in many healthcare organizations, as approximately half of all denials can be traced back to prior authorization and other front-end revenue cycle issues. This can jeopardize the financial health of a healthcare organization and negatively impact the patient’s financial experience by limiting transparency and delaying access to care.
AGS Health specializes in implementing streamlined workflows and managing standardized prior authorization processes with government and commercial payers, such as Medicaid, Medicare, managed care plans, and third-party insurance. Let us help you minimize denials and maximize your revenue.
SERVICES PROVIDED
Ensure patients are financially secure prior to service by obtaining timely preauthorization.
- Validate the necessity of authorization.
- Initiate submission of referral/authorization.
- Monitor and manage the process and timely follow-up through to completion.
- Proactive outreach with physician offices and patients to resolve issues and reduce errors.
BENEFITS
Unlock the benefits of prior authorization services
Improve Patient Access to Care
Expedite the prior authorization process for faster approvals and reduce treatment delays to improve access to necessary care and enhance patient satisfaction.
Manage Healthcare Costs
Increase compliance and approvals through clear communication and knowledge of requirements to minimize errors and maximize revenue.
Optimize Resources
Minimize the administrative workload on healthcare staff while effectively scaling resources to changes in volumes.
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Additional integrated financial clearance services to streamline your revenue cycle
Insurance Eligibility and Benefits Verification
Identify active third-party insurance coverage and benefits to reduce claim submission errors and back-end denials.
Patient Payment Estimation Services
Prepare for patient conversations on financial responsibility by collecting accurate good faith estimates.
Pre-Registration and Pre-Service Collections
Secure pre-service collections and patient education on estimated financial liability and payment options.
Resources
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