Expert Medical Billing

Prior Authorization Services

Faster Approvals • Fewer Delays • Better Patient Care

Reduce claim denials and patient waiting time with our comprehensive Prior Authorization Services — designed to simplify insurance approvals, improve efficiency, and help your practice get paid faster.

HIPAA-Compliant | 98 % Approval Success | Trusted Nationwide
Supporting Healthcare Providers Across the U.S.

Why Prior Authorization Matters

Insurance prior authorizations can consume hours of staff time and delay patient care. Every test, procedure, or prescription that requires payer approval can cause bottlenecks if not managed correctly — resulting in frustrated patients and delayed reimbursements.

At Expert Medical Billing Services, we handle the entire prior authorization process for you — from verifying medical necessity to coordinating with payers and tracking approvals.
Our expert team ensures compliance, accuracy, and speed, so you can focus on patient care while we handle the paperwork

prior authorization services
prior authorization in medical billing

How Our Prior Authorization Process Works

Verification of Requirements

Before services are rendered, we identify which procedures or treatments require authorization based on payer rules and patient plans.

Gathering of Clinical Information

Our team collects all supporting documents — including physician notes, lab results, imaging reports, and referral details — to meet payer requirements.

Submission to Insurance Payer

We complete and submit pre-authorization requests electronically or via fax/portal to insurance companies, following their specific formats.

Continuous Follow-Up

We track every submitted request, communicate directly with payers, and push for timely decisions to prevent patient delays.

Approval Confirmation & Documentation

Once approved, authorization numbers and validity dates are updated in your EHR or billing system for accurate claim submission and payment posting.

Common Authorization Challenges We Solve

Most healthcare practices struggle with authorization backlogs, unclear payer policies, and excessive denials.
Here’s how we fix them:

  • Unclear payer requirements: We maintain updated payer rules to ensure each request includes the right documentation.

  • Long approval times: Our follow-up team works daily with payer representatives to accelerate turnaround.

  • Missing clinical information: Automated checklists prevent incomplete submissions.

  • Denied authorizations: We identify root causes and re-submit appeals immediately.

  • Staff overload: We handle all administrative communication, freeing your team for patient care.

  • Inconsistent recordkeeping: Our system maintains an audit trail for every request, ensuring full visibility and compliance.

Specialties We Support

We support all major medical and dental EHR and billing platforms, including Athenahealth, Kareo/Tebra, eClinicalWorks, AdvancedMD, OfficeAlly, Epic, Cerner, OpenDental, Dentrix, Eaglesoft, CurveHero and more.

Cardiology

Endocranology

Neurology

Public Sector

Radiology

OB/GYN

Nephrology

Urology

What We Offer

We combine automation and human expertise for unmatched accuracy.
Our Authorization Tracking System integrates with your existing EHR or PMS to:

  • Flag procedures that require prior authorization automatically

  • Track pending requests in real time

  • Send alerts for expiring authorizations

  • Provide detailed payer-specific approval timelines

  • Maintain secure, HIPAA-compliant document storage

This intelligent workflow ensures no missed approvals, no expired authorizations, and no preventable denials.

Why Choose Expert Medical Billing Services

AdvantageWhat It Means for You
98 % Authorization Success RateFaster approvals, fewer delays
Full-Service HandlingVerification, submission, tracking, and follow-up
Trained Authorization SpecialistsExperienced across all payer portals and EMR systems
Nationwide Coverageserving all U.S. regions
HIPAA-Compliant OperationsTotal patient data security
24–48 Hour TurnaroundFaster responses for urgent cases

Our prior authorization team becomes a direct extension of your practice, providing constant communication and transparency at every step.

 

Our Authorization Service Includes

  • Eligibility and benefits verification
  • Determining authorization requirements per payer

  • Gathering and validating clinical documents

  • Submission of prior authorization requests

  • Payer communication and follow-up

  • Re-submission of denied authorizations

  • Documentation of approval numbers and dates

  • Updating EHR systems with authorization status

  • Authorization renewal tracking

  • Monthly reporting on approval trends and turnaround times

Get a Complimentary Financial Health Audit for Your Practice

Features You Can Rely On

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KPI Dashboard

  • Visibility into performance indicator such as copays collected, AR per payors, denials, and cash flow in real time.
  • View and evaluate your practice revenue to monitor your billing team’s performance.
  • Overview of daily appointments and updated patient balances to improve collection at the time of service.

Check-In Validation

  • Insurance and benefits eligibility is automatically validated in advance with real-time verification at check-in.
  • The most up-to-date patient balance information is available on the scheduler. The system also prompts for copay collection to ensure collection at the time of service.
  • Easily collect self-pay and copay via credit card, or other payment types, or quickly set up a payment plan if required—all to help your bottom line and improve financial results.

e-super Bill

Our e-super bill feature recommends the level of evaluation and management (E&M) code that will be appropriate against the provided information. It also outlines missing components, if any, for a particular level of E&M coding, greatly reducing the chances of up/down coding and eliminating the need to hire a separate coder to audit the level of documentation against each claim.

Advanced Reporting

With online reporting and analytics, you have complete financial visibility anytime, anywhere. Our medical billing software provides preformatted reports to measure your practice performance and highlight areas for improvement, as well as customized reports for insight into your unique pain points and performance initiatives.

Our Clients Are Making Healthcare Better

40 % Faster Authorization Turnaround
30 % Fewer Claim Denials
24–48 Hour Average Approval Window

Frequently Ask Questions

We manage prior authorizations for diagnostic imaging, lab tests, surgeries, medications, physical therapy, and specialist visits.

Most authorizations are completed within 24–48 hours, depending on payer response times and required documentation.

Yes, we integrate with all major systems like Athenahealth, Kareo, AdvancedMD, and eClinicalWorks for seamless updates.

Absolutely. Our dedicated team manages urgent cases with expedited payer communication and priority tracking.

No. While our offices are in Orlando, FL and Roanoke, VA, we serve healthcare providers nationwide through HIPAA-secure systems.

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