Prior Authorization & Referrals
Eliminating Bottlenecks and Securing Timely Payer Approvals
Your Gateway to Approved Services and Expedited Care
Prior Authorization (PA) and referral coordination are often major friction points in the revenue cycle, leading to delayed services and patient dissatisfaction.
Nexiqor specializes in streamlining this critical administrative function.We manage the entire PA process—from initial verification to final approval—ensuring all necessary clinical documentation is submitted correctly the first time.
Our service minimizes coverage gaps, reduces service denials, and allows your clinical staff to focus purely on patient care.
Prior Authorization Management
We handle all aspects of PA, including checking specific payer requirements, accurate form submission, tracking approval status, and managing urgent turnaround times to prevent service delays.
Insurance Verification
Comprehensive real-time verification of patient insurance coverage, eligibility, and benefits. This step confirms payer requirements, identifies co-pays/deductibles, and pre-empts authorization related denials.
Referral Coordination
Efficiently manage incoming and outgoing patient referrals. We ensure all referral processes align with managed care contracts and specialist requirements for seamless transition and accurate billing.
PA Status Monitoring and Appeals
| Proactive tracking of pending authorizations and rapid intervention to address any information requests from the payer. We manage complex appeals for denied authorizations, fighting for patient access to necessary care. |
