Authorizations & Referrals

We manage the entire prior authorization and referral process to ensure your services are approved before delivery. Our dedicated team navigates complex payer requirements, submits complete requests, and follows up persistently to secure timely approvals—eliminating denials and revenue delays.

Key Aspects of Mental Health & Wellness

Prior authorization requirements are increasingly common and notoriously complex. Our authorization specialists understand payer-specific requirements, clinical criteria, and documentation standards for all major insurers. We manage authorization requests from initial determination through approval, ensuring all necessary information is submitted correctly the first time.

Prior Authorization Management

The ability to manage emotions, such End-to-end management of prior authorization requests for procedures, medications, and services. We verify requirements, gather clinical documentation, submit requests, and track status until approval is secured.

Referral Coordination

Complete referral management for HMO and managed care plans. We obtain required referrals, track expiration dates, coordinate renewals, and ensure proper documentation to prevent claim denials.

Expedited Processing

Urgent authorization requests for time-sensitive procedures and medically necessary services. We utilize peer-to-peer review processes and expedited channels to secure rapid approvals when clinically indicated.

Appeals & Denials Management

Expert handling of denied authorization requests including clinical appeal letters, peer-to-peer reviews, and external review processes. We fight for coverage when services are medically necessary.

Eliminating Authorization-Related Denials

Missing or denied authorizations are a leading cause of claim denials and patient dissatisfaction. Our proactive approach identifies authorization requirements during scheduling, initiates requests immediately, and follows up daily until approval is obtained. We maintain detailed tracking systems, provide regular status updates to clinical staff, and ensure authorization numbers are documented before services are rendered. This comprehensive management prevents revenue loss and delays while improving patient access to needed care.

How long does the authorization process take?

Standard authorizations typically take 3-7 business days, though some payers respond within 24-48 hours. Complex cases or specialty medications may require 10-14 days. Urgent/expedited requests can be processed in 24-72 hours when medical necessity is documented. We initiate requests as early as possible to avoid delays.

Do you track authorization expiration dates?

Yes, we maintain detailed tracking of all authorization approval dates, authorized units/visits, and expiration dates. We proactively request extensions or new authorizations before current approvals expire to ensure continuity of care and prevent claim denials. Regular reports are provided to your clinical and billing teams.

What are common mental health disorders?

We provide counseling, therapy, stress management programs, psychiatric evaluations, medication management, mindfulness training, and wellness programs

How can I manage stress and anxiety?

We provide counseling, therapy, stress management programs, psychiatric evaluations, medication management, mindfulness training, and wellness programs

Authorizations & Referrals