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Prior authorization specialist

A specialist who gets prior authorization approved before the service is delivered.

What they do

  • Submit pre-authorization requests to the insurance companies
  • Follow up until each one is resolved
  • Check authorization status in the payer's database
  • Determine what further documentation is needed and request it
  • Arrange physician peer-to-peer review where the payer requires it

Channels

Online payer portals, phone and fax.

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