Prior approval is essential to the healthcare revenue cycle because it offers both healthcare providers and their patient’s significant protection. Except in an emergency or critical situation, healthcare providers must follow the payer’s rules regarding the location of the service, the cost of the treatment, the choice of medication, and the status of coverage for complicated or expensive procedures. The patient may incur significant financial obligations for not obtaining prior authorization, and the provider may experience a loss of revenue.

Healthcare professionals are dedicated to giving each patient who comes to their office the best care attainable. One of their main duties is to help patients understand the best options for achieving their desired outcomes while selecting a treatment plan that complies with the standards set by the relevant payer. To guarantee that the patient has coverage for and access to these services, providers must also obtain prior authorization from the payer for any anticipated diagnostics, medications, or procedures. To achieve satisfactory results, doctors may suggest or select alternative treatment options that are covered by the patient’s insurance. Healthcare providers can improve patient satisfaction and guarantee financial
protection through the payer’s policies by making these issues clear.

Prior Authorization services are our area of expertise at Revelationcare, and we help healthcare providers optimize collections and streamline their revenue cycles. To reduce human effort, improve quality, and quicken turnaround times, we work with top solution providers.