Pre-certification, also known as prior-authorization or prior approval, occurs before care is rendered. A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary. A request for authorization must be set forth on the prescribed form or format by your insurer along with the required information for Utilization Review Department at insurance to make a decision whether the medical treatment or services requested is medical necessary or not.
Prohealth offers this much needed service for insurance authorization as a part of the complete RCM Solutions Package.
Prohealth offers medical billing services, focusing on every aspect of the medical billing / patient cycle. We strive to achieve the best possible timely reimbursement for our clients, as the faster one can prepare a bill, the faster and clean the claims the sooner the reimbursement. With this in mind we work 24x7 and have dedicated billers and billing analysts to work while you sleep.
