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Authorization refers to the procedure of obtaining approval from a health insurance company to administer medical treatment or procedures to a patient, thereby preventing claim denials and reducing the financial burden on the patient after the treatment. Services administered without authorization can be denied or not reimbursed. Our authorization process also helps in preventing unnecessary treatments and speeds up the billing process.

Our services act as a bridge between insurers and providers, ensuring that all treatments are properly approved, accurately recorded, and promptly paid for.

Why Is Authorization Important?

Confirms Insurance Coverage

Healthcare providers can use our prior authorization to obtain approval from the insurance provider for their payment.
Prevents Claim Denials

Without our authorization, the payer may deny the insurance claim if they deem it unnecessary. It helps prevent last-minute cancellations and coverage issues.
Reduces Financial Burden

We help our patients to schedule medical treatment so they don’t have to stress about their medical bills.
Documentation

We make sure all the procedures are documented, and also determine the necessity of the procedures.
Legal and Regulatory Compliance

We make sure that insurance providers cannot dodge the payments and ensure services meet medical requirements.
Transparent Communication

When we do our authorization, patients know what to expect financially and also make informed decisions regarding their health.

For almost a decade, our staff of more than 200+ AAPC-certified Indian coders has been expediting medical billing services for healthcare professionals in the United States. In addition to providing specialised services and increasing your profit by at least 30%, we also plan conditions unique to your speciality and are accessible around the clock.

With 25+ years of experience, our offshore billing processes guarantee operational efficiency and regulatory compliance by adhering to industry best practices established by the Healthcare Billing and Management Association (HBA) and the Healthcare Distribution Management Association (HDMA).

Types Of Authorization

Prior Authorization

It refers to the authorization process before the medical treatment to ensure that their insurance will cover the medical service. It is used for non-emergency medical services.

Concurrent Authorization

It is the authorization for medical services that are currently in progress, for example, an extended hospital stay. It ensures the insurance company covers the expenses that are beyond the initial authorization.

Retro Authorization

It is used for emergency services where prior authorization wasn’t possible. It also carries the risk of the payer denying the insurance claim.

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How Is Our Authorization Process Carried Out?

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Verify Your Insurance

A healthcare provider or our billing staff will check the patient’s insurance plan, procedure, or service code and ICD code.

Collect the Necessary Documents

We collect important data like patient demographics, insurance plan details, procedure codes, diagnosis codes, date, and location of the service.

Request For Authorization

Our authorization request is submitted via online portal, fax, or a phone call, along with supporting documents such as medical records and lab results.

Review By The Insurance Provider

Your insurance provider may review and determine the necessity of the medical procedure.

Receive Your Authorization Number

If our authorization is approved, your provider will receive an authorization number, then inform the patient and proceed with care.

Appeal If Your Authorization Is Denied

We try to understand the reason for the denial and contact the insurance company. We gather the necessary documents and submit an appeal within the deadline. If you find any errors like wrong code or missing information, we can correct them and resubmit the authorization request instead of appealing.

What Are The Common Reasons For Denial?

Incorrect Patient Info

No Prior Authorization

Duplicate Requests Or Already Authorized

Late Submissions

Non-Covered Service

Expired Authorization

Lack Of Medical Necessity

Seamless integration across platforms

ICS RCM services work with a variety of EHRs and PM systems, including:

Easy Integration with Over 40 Leading Medical Billing Software Platforms

By working with over 40 significant industry multi-platforms, we guarantee seamless integration with top billing systems. We have experience with every major platform used by healthcare professionals worldwide, including AdvancedMD, Athenahealth, and Kareo. Our multi-platform knowledge allows us to offer accurate, efficient, and workflow-specific offshore medical billing services that minimise practice disruptions and maximise revenue cycle performance.

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Faster Recovery, Guaranteed Revenue — Driven by Our Custom-Built System

In order to maximise customer collections with unmatched accuracy and speed, we have created our client recovery system. Our service ensures efficient processing of out-of-network claims and is now integrated with over 500 payers. Additionally, our system has an AI-based function that operates automatically and allows for one-click insurance claims processing, giving users quick access to and usage of all necessary data.

By providing flexible contracts, robust data security protocols, and professional assistance for complex billing situations, we help healthcare providers recover faster without compromising control or compliance.

Whether you operate as an individual practitioner or manage a healthcare association with multiple sites, we offer a solution tailored to your requirements.

What Happens If our Authorization Is Skipped?

Financial Burden

Without our authorization, the financial responsibility falls on the patient, which can lead to billing disputes and unexpected costs.

Claim Denials

Your healthcare provider may not receive their payment, and the insurance may never be reprocessed or reimbursed if not checked quickly.

Time-consuming Appeals

It might require multiple resubmissions and appeals if the retro authorization is denied.

Damage to Reputation

It results in damage to trust between the patient and the provider, which can lead to patient dissatisfaction and negative reviews.

Delayed Reimbursements

It can result in the disruption of cash flow for providers.

Miscommunication

Skipping prior authorization can lead to communication errors and erosion of trust of the patient.

Delayed Treatment

Treatments can be postponed due to a lack of authorization.

Workflow Disruption

Re-working the denied claims can cause unnecessary time consumption and disruption of workflow.

Risk of Out-of-network Issues

If you don’t complete the authorisation, you won’t be aware that certain services may be considered out-of-network.

Services Across 35+ States

We take pride in providing trustworthy, lawful, and efficient medical billing solutions that meet the local requirements of over 35 healthcare providers in the US and comply with their billing regulations. Our staff is knowledgeable with payer policies and state-specific regulations to ensure accurate invoicing and timely reimbursements, regardless of the size of your practice or multispecialty organization.

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Contact us right now to increase revenue flow, expedite authorisations, and provide continuous patient care

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Expert Medical Billing for Every Specialty

Assuring Fewer Denials and Quicker Claims

Authorization In Medical Billing

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Why Is Authorization Important?

Confirms Insurance Coverage

Prevents Claim Denials

Reduces Financial Burden

Documentation

Legal and Regulatory Compliance

Transparent Communication