Prior Authorization

As health insurance is constantly evolving with newer legislations & practices, prior authorization continues to become the cornerstone of administrative functions. The in-house team can be overwhelmed by its complexities, which in turn can have a negative influence on your practice’s finances. You can rest assured that Sunknowledge & its consultative aptitude, with best-in-class solutions in prior authorization (also referred to as pre-certification or pre-authorization) will handle all operational hassles so you can focus on your care management priorities.

We are your one-stop address & the perfect mediators with the Payor, dedicated to help you remove all obstacles in your pre-cert process that are hurting your bottom line. We offer a 3600 program in practice management with an exclusive skill-set that starts with a synchronized process of collection of patient information to availing prior authorization for both inpatient & outpatient services.

We also look to add value with our thorough benefits verification services that remove unpleasant surprises in the path to claims submission and payment, thanks to our proven methodology to eliminate errors quickly and address issues effectively.

Our resources are dedicated experts with extensive knowledge about the checks & balances in practice management & help you reap real-time benefits with excellent relationship management skills with the insurers. Our zero client attrition for the last 7 years is largely due to our comprehensive understanding of Payors’ claims adjudication priorities.

We are also partners with two of the country’s largest companies in insurance dealing with health plans. Our unique best practices will help you achieve a better denial management process.

Highlights

  • Turnkey all-inclusive prior authorization services (Authorization Request + Follow-up + Approval)
  • 100% HIPAA compliance
  • Rx notification to the pharmacies (For prior authorization on medication)
  • Scheduling delivery of drugs with pharmacies
  • Competitive pricing, with no overtime and zero overhead
  • Helping you focus on patient-centric activities
  • Long standing alliances with leading health insurers
  • Flexible engagement model without lockup or binding service clauses

Are You Looking for streamlined medical billing assistance?

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Enough of us! Lets know about your areas of interest! Get connected for a quick discussion on how we can elevate your revenue cycle management experience by working as a seamless operational extension.