Pre-Authorization / Pre-Certification 

Front Office Services:

The best method to reduce the AR days and maximizing the collections is to restrain the denials before it occurs. CNTI ensures right steps are taken prior to the service being rendered including: Appointment scheduling, Pre-verification and Pre- Authorization.

 

Pre-Authorization

Pre-Authorization is the process of getting the prior approval / notification for a service from the insurance carrier. Obtaining proper Pre-Authorization, prior to the service being rendered results in prompt payment and decreases write-offs.

CNTI’s Pre-Authorization Team obtains the Pre-Authorization on behalf of the Dr’s Office or a facility thus easing the burden of the Front desk. Our specialists contacts the Care Management Department, responsible for approving pre-authorization and

  • Place the Request on behalf of the Client
  • Explain the Medical necessity
  • Obtain the Prior authorization within 24 to 48 hours
  • Confirms to the Physician Office whether the service can be rendered on the scheduled date or rescheduled.
  • Report the approved and denied authorization information well ahead of the patient’s schedule.

 

Importance of Pre-Verification:

Insurance Verification is the very first step once the patient is scheduled for an appointment. This process is the best method to lowers the denials from the payer resulting increased revenue. Patient benefit verification provides detailed information to the provider on the reimbursement and the patient liabilities.

CNTI Benefit Eligibility Verification Solution provides real-time validation of patient’s health insurance. Highly proficient specialists work with the Patients, Providers and the Health insurances to identify the coverage benefits. Every new and existing patient’s information are verified prior to the service are rendered. The dedicated eligibility verification team validates the patient’s insurance coverage and the financial obligation. Additionally the team contacts the patient and makes them understand their financial obligation, thus validating the payment that can be expected from the patient and from the payer.

 

Key highlights of CNTI Pre-Verification Services:

  • Minimizing the denials and improved collections
  • Reduction in write-offs
  • Making the patient understand their financial obligation
  • Physician Office can focus on patient centered services
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