Prior Authorizations Handled — Without Delaying Patient Care

Authorization paperwork shouldn’t decide when your patients get treated. Our team identifies which services need approval, compiles clinical documentation, submits requests, and pushes payers until determinations come back.

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A Core Axis specialist will reach out within one business day.

Is This Costing Your Practice Revenue Right Now?

Most practices carry these problems for years without measuring what they cost. Here’s where the money usually goes.

Days lost

Delayed treatment

Patients wait while authorization paperwork sits in payer queues.

Denied

Incomplete requests

Missing clinical documentation sinks otherwise valid authorizations.

Write-off

Missed auth entirely

Services delivered without required approval frequently go unpaid.

Hours

Clinical staff on phones

Nurses chasing approvals aren't doing the work they trained for.

Everything This Service Covers

Delivered by a dedicated team, inside your systems, with fully HIPAA-compliant data handling.

Requirement Screening

Every scheduled service is checked against payer policy to confirm whether auth is required.

1

Clinical Documentation Prep

We assemble the notes, imaging, and history payers ask for — complete on the first submission.

2

Submission & Tracking

Requests filed via portals, fax, or phone, then tracked daily until a determination is issued.

3

Urgent & Expedited Requests

Time-sensitive cases escalated through payer expedite channels with clinical justification.

4

Denial & Peer-to-Peer Support

Denied authorizations appealed, with peer-to-peer reviews scheduled for your providers.

5

Retro Authorization Recovery

Missed authorizations pursued retroactively where payer policy allows.

6

Built to Protect Your Revenue

Authorization denials are doubly expensive: you lose the reimbursement and the patient loses time. A dedicated team that lives inside payer requirements keeps both from happening.

Authorization failures are the only billing problem that hurts twice. Miss one, and the practice loses the reimbursement — payers rarely pay for services that required approval and didn’t get it. But the patient loses too: procedures postponed, treatments delayed, care rescheduled around paperwork. No other revenue cycle failure lands this directly on clinical care.

The workload is why it breaks down. Every payer keeps different rules about which services need approval, what clinical documentation proves medical necessity, and how requests must be filed — and the rules change without announcement. Practices that assign authorizations to whoever has a spare moment end up with incomplete requests, unmonitored statuses, and clinical staff burning hours on hold.

How We Deliver Prior Authorization Services, From Day One

Switching sounds disruptive. Our onboarding is designed so it isn’t — with zero revenue interruption during transition.

1 Identify

Orders and schedules are screened for services that require payer approval.

2 Prepare

Clinical documentation is compiled to match each payer’s medical-necessity criteria.

3 Submit & Chase

Requests are submitted and followed up on a daily cadence until approved.

4 Confirm

Approval numbers and validity windows are logged in your system before service.

In-House vs Core Axis The Real Numbers

The question isn’t whether outsourcing costs money — it’s whether your current setup is costing you more.

Metric

Typical In-House Setup

Core Axis Healthcare

Annual cost

$50K–$70K per biller plus benefits, training, and software

One transparent rate — team, tools, and expertise included

Clean claim rate

85–92% industry average

98%+ first-pass acceptance

Denial rate

5–10%, with costly rework

Driven down 15%+ through prevention

Days in A/R

Often 40–55 days

Actively worked toward under 30

Coverage

One person’s knowledge — gone when they leave

A full team with backup, always staffed

Scalability

Hire-and-train cycles lag your volume

Scales instantly with patient volume

Technology

Billing software billed separately

Included in the service

Compliance

Liability sits fully on your practice

HIPAA-compliant processes with a dedicated teama

Reporting

Core Axis Healthcare

Scheduled monthly reports with walkthroughs

Specialty-Specific Expertise for Every Practice Type

Every specialty has its own code sets, modifier rules, and denial triggers. Our specialists are trained in yours — across 50+ specialties.

Cardiology

Echo, stress tests, and modifier billing require payer-specific expertise.

Orthopedics

Surgical packages and fracture care demand precise coding accuracy.

Dermatology

Lesion procedures and biopsies require compliant coding and modifiers.

Neurology

EMG, EEG, and nerve studies require specialty coding expertise.

Gastroenterology

Endoscopy procedures require accurate coding and bundling compliance.

Radiology

Professional and technical billing requires accurate modifier application.

OB/GYN

Maternity care and procedures require precise global billing expertise.

Pediatrics

Vaccines and preventive visits require age-specific coding accuracy.

Physical Therapy

Timed therapy services require accurate documentation and coding.

Pain Management

Injection procedures require authorization and precise coding compliance.

Internal Medicine

Chronic care and E/M coding require complete documentation.

Behavioral Health

Therapy sessions require compliant coding and documentation accuracy.

Your Patient Data, Protected at Every Step

HIPAA Compliant

Every workflow operates under HIPAA Privacy and Security Rule safeguards for PHI.

Encrypted Data

Patient information travels and rests only through encrypted, access-controlled channels.

BAA Provided

A signed Business Associate Agreement is in place before we touch a single record.

Audited Processes

Regular internal audits and staff screening keep our security posture current.

Provider Enrollment & Credentialing: Your Questions Answered

How fast do you get authorizations?

Turnaround depends on the payer, but every request is tracked daily and urgent cases are pushed through payer expedite channels with clinical justification.

What do you need from our practice?

Access to orders and clinical documentation. We compile the notes, imaging, and history each payer’s medical-necessity criteria require.

What if an authorization is denied?

We file appeals with supporting documentation and schedule peer-to-peer reviews for your providers when payers require clinician conversations.

Can you recover missed authorizations?

Where payer policy allows retroactive authorization, we pursue it — recovering revenue that would otherwise be written off.