Treatment without an approved authorization often goes unpaid. We submit the request with the Plan of Care and supporting documents, then track the approval, the authorization number, the approved units and the dates it covers.
Prior authorization is approval from the insurance plan before a service is given. Many plans require it for therapy services. If the provider treats without it, or keeps treating after the approved units run out, the claim is usually denied.
Our team handles prior authorizations for physical, speech, occupational and feeding therapy and for Prescribed Pediatric Extended Care (PPEC). We submit each request through the payer's portal, by fax or by mail, depending on what the plan accepts, and attach the Plan of Care and the supporting documents the plan asks for.
After submission we track the request until a decision comes back, then record the authorization number, the number of approved units and the effective dates, so your schedulers and billers can see what is covered. Most of our authorization work so far has been with Florida Medicaid plans.
Each plan has its own forms and rules. We follow the payer's requirements for each request.
Using something else? Tell us which system you use. We will say plainly whether we have worked in it before.
Our parent company, Hire My Assistants KPO LLP, is HIPAA compliant.
We sign the Business Associate Agreement your practice or plan uses, before any access is set up.
We work directly in your billing or claims system, or through the VPN or virtual desktop you provide. We never download or store patient data.
Restricted, monitored workstations, multi-factor login, encrypted devices, and access logs. No phones or writing material on the floor.
Every team member passes police verification and an outside background check, and completes HIPAA training when they join the team.
Tell us your therapy services, your main plans and how many authorizations you request a month. We reply within one business day.