Prior Authorization Services
Prior authorization, handled from order to decision.
Advantum manages prior authorization and eligibility verification end to end, connecting directly to your EHR and payer portals. Physicians return to medicine. Billing teams return to billing.
Schedule a conversation
Talk to a prior authorization specialist. Response within one business day.
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No obligation. Response within one business day.
Recognized for performance and culture
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Results from practices that made the move
Advantum runs prior authorization on its own or as part of full-scope revenue cycle management. Here is what each looks like.
High-volume urology practice rebuilt prior authorizations for scale
Download the case study →"The partnership has had a clear operational impact. With prior authorizations off our team's plate, staff are able to focus on their core responsibilities and patient care, and turnaround times have improved. The Advantum Health team has been consistent and dependable."
Melanie S., Director of Operations, High-Volume Urology Practice
Multisite gastroenterology practice restored financial control
Download the case study →"Since we have been with Advantum, we have enjoyed a tremendous return on our investment and fully expect the same results for going forward due to improved performance in AR collections, prior authorizations, reduced denials, and lower operating cost due to increased automation and lower staffing costs."
Don S., CEO, Gastroenterology Group
Prior authorization and eligibility, managed as one workflow
Advantum manages prior authorization and eligibility verification as one connected workflow. By the time a service is scheduled, eligibility is verified, the authorization is on file and the documentation is complete. Our team owns every follow-up.
Eligibility & benefits verification
Insurance coverage confirmed before every appointment, not just at scheduling. Eligibility mismatches discovered at the point of service create avoidable claim rejections and patient balance disputes.
Prior authorization submission
Complete, accurate submission to payers the first time. We verify requirements by payer and specialty before submitting.
Status tracking & follow-up
Every open authorization is tracked through Advantum One. We follow up with payers before requests stall.
Criteria sheet completion
Payer-specific criteria and forms completed accurately for each request. The wrong form or a missing field is enough to trigger a denial or restart the clock on a decision.
Denial review & appeal support
When a prior authorization is denied, we review the reason code, identify the gap and manage the appeal or peer-to-peer review process.
Process optimization & reporting
Analytics on authorization turnaround times, denial reasons and approval rates by payer and service type. The data tells you where the bottlenecks are. We use it to eliminate them.
What your team gets back
When prior authorization runs as a managed process instead of an ad hoc task, denial rates drop, physician time is recovered and claims move faster.
Every authorization tracked from submission through the date of service.
Payer status checks handled by our team, so your staff stays on its own priorities.
Complete documentation on the first submission, so physician time goes to patients.
Eligibility confirmed at the point of service, not just at scheduling.
Every high-cost service verified before it proceeds.
A dedicated authorization process, so physicians no longer do the paperwork.
Ready to take authorization off your team's plate?
Talk to a prior authorization specialist. We review your current workflow and show you how our team handles submission, follow-up and tracking.
No obligation. Response within one business day.