Prior Authorization Services

Approvals chased before the appointment, not after the denial.

Prior authorization is an administrative race, not a clinical debate. Reveno MD raises the request at scheduling, assembles the clinical documentation, chases the payer daily and tracks every expiry, so treatment is never held up and the claim never comes back unauthorized.

Requests raised at scheduling Daily payer follow-up Expiry and visit counts tracked
  • Peer to peer calls coordinated
  • Appeals filed inside the window
  • Retro requests where payers allow
Where treatment stalls

The approval never came, so the day fell apart

This is a staffing problem dressed as a clinical one. We take the whole authorization workflow off your desk and run it inside your existing systems.

94%A procedure cancelled on the morning because the approval never arrived

of physicians report that prior authorization causes delays to patient care.

13 hoursDenials for care that was clinically necessary and simply unauthorized

a week is what a typical practice spends on authorization admin.

Around 25%Staff sitting on hold with payers instead of dealing with patients

of authorization denials are overturned on appeal, which means they should not have been denied.

Most refusals are process failures, not clinical ones.

  • 0Day average turnaround
  • 0Requests approved
  • 0Staff time saved weekly
  • 0Status updates
What we offer

From the benefit check to the appeal, and everything between

We take the whole authorization workflow off your desk and run it inside your existing systems.

Benefit and requirement check

Before anything is scheduled we confirm whether the service needs authorization for that plan, that site of service and that code.

Request submission

Filed through the payer portal, fax or phone line the plan actually prefers, with every required field completed the first time.

Clinical documentation assembly

Notes, imaging, conservative treatment history and medical necessity language pulled together so the reviewer has no reason to ask again.

Peer to peer coordination

When a plan requests a clinical discussion we schedule it, brief your provider and make sure the slot is not wasted.

Daily status tracking

Every open request is checked against the payer, with a written status you can see rather than a note in someone’s head.

Expiry, unit and visit tracking

Date ranges, visit counts and unit limits monitored, with extensions requested before the course of treatment runs out.

Appeals and reconsiderations

Denials appealed inside the window with payer-specific language and the evidence the first submission was missing.

Retro authorization requests

Where a plan permits retrospective review, we file it with the justification rather than writing the claim off.

Your growth starts here

Send us a week of your scheduled procedures and we will show you which ones need authorization, which are at risk, and what the current process is costing you in cancellations.

Why hand it over

The work is relentless, repetitive and unforgiving

It rewards persistence rather than skill, which is exactly why it should not sit with clinical staff.

Book a free prior auth review
Raised before the visitRequests start at scheduling, not at check-in when it is already too late.
Chased every working dayPayers move files that are being asked about. Ours are asked about daily.
Documentation done properlyMost refusals are missing evidence, not clinical disagreement.
Nothing expires unnoticedDate ranges, visit counts and unit limits all sit on a tracked calendar.
Wired into your billingThe same team works your denials, so an authorization problem never becomes a write-off.
How it runs

Five steps, starting the moment a procedure is scheduled

Seamless process, measurable impact.

STEP 01

Requirement check at scheduling

The plan, the code and the site of service are checked before the appointment is confirmed, so nobody discovers a requirement on the day.

STEP 02

Documentation pack

We assemble the clinical evidence the payer asks for, including conservative treatment history where the policy requires it.

STEP 03

Submission

The request goes in through the channel that plan prefers, with a reference number logged against your schedule.

STEP 04

Daily follow-up

Open requests are chased every working day. If a peer to peer is needed we book it and brief the provider.

STEP 05

Track and extend

Approvals are recorded with their date range and visit count, and extensions are requested before anything lapses.

Proven results

What changes when authorizations are actually managed

Typical position before and after, across the practices we support.

MetricBefore Reveno MDWith Reveno MD
Average turnaround10 to 14 days2 to 4 days
Same-day cancellationsRegularRare
Authorization-related denialsA steady share of A/RClose to eliminated
Expired authorizationsFound after a denialExtended before expiry
Staff hours on holdAround 13 a weekReturned to patient care
Client results

What our clients say

PMPractice ManagerOrthopedic group

Same-day cancellations basically stopped. Our schedule finally holds.

DNDr. N. OkaforPain management

Our staff were spending most of a day a week on hold. That time went straight back to patients.

DPDr. P. SalviGastroenterology

They appealed three authorizations we had already written off, and won all three.

Prior Authorization at Reveno MD

Stop losing procedures to paperwork

Send us a week of your scheduled procedures and we will show you which ones need authorization, which are at risk, and what the current process is costing you in cancellations.

  • A requirement check on your real schedule
  • An estimate of hours currently spent on hold
  • Authorization-related denials quantified
  • No obligation and no contract to sign
Questions practices ask

Frequently asked questions

It varies by plan, but commonly advanced imaging, surgical procedures, injections and blocks, infusions and specialty drugs, durable medical equipment, and therapy beyond a set visit count. We check the requirement per plan and per code rather than assuming.

Most requests are decided in two to four days when they are submitted complete and chased daily. Urgent requests are flagged to the payer as expedited, which many plans decide within 72 hours.

We look at the reason first. Most refusals are missing documentation rather than a clinical disagreement, and those are resubmitted. Where the plan wants a clinical discussion we arrange the peer to peer and brief your provider.

We coordinate them. We book the slot, confirm it with your provider and make sure the relevant notes are in front of them beforehand. The clinical conversation itself is between your provider and the payer’s reviewer.

Every approval is logged with its date range, visit count and unit limit. Extensions are requested before the limit is reached, not after a claim is denied.

Yes. Prior authorization can be taken on its own, and we report into whoever runs your billing. It works better alongside our billing service because the same team sees the denials, but it is not a requirement.