Our expert pre-authorisation services remove the administrative burden from your clinical staff. We gather documentation, submit requests, and track status with payers to secure approvals—ensuring patients receive timely care while protecting your revenue cycle.
Navigating payer requirements for complex procedures, imaging, and specialty medications requires precision. Utilizing professional pre-authorisation services ensures clinical documentation is submitted correctly the first time. Following guidance from resources like the AMA, effective prior authorisation workflows prevent medical necessity denials and stop costly treatments from going unpaid.
Identify procedures requiring authorisation prior to scheduling
Gather supporting clinical documentation, CPT, and ICD-10 codes
Manage peer-to-peer reviews and track approval statuses daily
A dedicated team that acts as a liaison between your clinical staff and insurance payers, fighting for approvals so your providers can focus on medicine.
We extract necessary clinical notes, imaging reports, and letters of medical necessity directly from your EMR to build a compelling case for approval.
Submission of auth requests via web portals, fax, or phone, ensuring all specific payer criteria and step-therapy requirements are met.
Relentless daily tracking of pending requests to ensure payers do not stall or arbitrarily delay critical patient treatments.
When an auth is flagged for review, we coordinate schedules between your physician and the payer's medical director to secure overturning of denials.
Handling emergency admissions or urgent procedures where care was rendered immediately, securing retroactive approval within strict payer windows.
Monitoring approved authorisations for expiration dates and maximum unit limits, securing necessary extensions before a patient's care plan is interrupted.
Your providers enter orders for surgeries, imaging, or medications. Our team identifies which ones require payer auths.
We extract the exact clinical documentation required by the specific payer and submit the comprehensive auth package.
We monitor the request daily. If additional information or a peer-to-peer review is requested, we facilitate it immediately.
The auth number, approved dates, and authorized units are logged securely into your PM software for claim generation.
Navigating insurance bureaucracies drains clinical hours. We take over the entire process so your nurses and doctors can focus entirely on patient care.
Our tailored pre-authorisation services include specialized clinical knowledge, complex retro-authorisations, and robust tracking logic across 40+ practice types.
See how we’ve helped medical centers eliminate denials and streamline front-office operations.
"Since Synergy took over our prior authorisations, our nursing staff got their time back. We no longer spend hours on hold with payers, and our approval rates have never been higher."
"Their handling of complex surgical pre-authorisations is flawless. We rarely have to delay treatments anymore because they stay on top of the payers until approval is secured."
"The way they coordinate peer-to-peer reviews is incredibly efficient. It takes the administrative headache entirely off my plate so I can just focus on the clinical discussion."
"The ROI is undeniable. Preventing a medical necessity denial on the front end by securing an auth is infinitely cheaper than having our billing team chase appeals on the back end."
"Since Synergy took over our prior authorisations, our nursing staff got their time back. We no longer spend hours on hold with payers, and our approval rates have never been higher."
"Their handling of complex surgical pre-authorisations is flawless. We rarely have to delay treatments anymore because they stay on top of the payers until approval is secured."
"The way they coordinate peer-to-peer reviews is incredibly efficient. It takes the administrative headache entirely off my plate so I can just focus on the clinical discussion."
"The ROI is undeniable. Preventing a medical necessity denial on the front end by securing an auth is infinitely cheaper than having our billing team chase appeals on the back end."
Get a free consultation to see how our pre-authorisation services can eliminate administrative bottlenecks and accelerate your patient care.
