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Everest AR
Services / Prior Authorization

Prior Authorization Services

Streamlined auth workflows that eliminate phone holds and fax machines so your staff can focus on patients.

Hands-off

For your staff

Complete

Documentation

Tracked

Every auth

Appeals

On denials

The Problem We Solve

35 hrs

Per week on prior auth

The average practice spends on phone holds, faxes, and follow-ups.

34%

Claims denied for no auth

The single most preventable denial type — and the most costly.

78%

Of physicians report delays

Prior auth delays cause patient care delays, not just revenue loss.

What’s Included

Auth Requirement Detection

We check every scheduled procedure against payer requirements. Never miss a required authorization.

Submission & Documentation

Complete auth packages submitted with all required clinical documentation. Nothing missing, nothing delayed.

Payer Follow-Up

We follow up with payers so your staff doesn't have to. No more 45-minute phone holds.

Status Tracking & Alerts

Real-time visibility into every pending auth. Automatic alerts for approvals, denials, and expirations.

Denial & Appeal Management

When an auth is denied, we appeal immediately with additional supporting documentation.

Retro Authorization

For urgent or emergent cases, we handle retroactive auth submissions to recover revenue.

How It Works

1

Step 1

Assessment

We review your current auth volume, payer mix, and denial patterns. Identify where time and money are being lost.

2

Step 2

We Take Over

Our team begins managing all prior authorizations. Your staff stops making payer calls on day one.

3

Step 3

You See the Difference

Approval rates climb, auth-related denials drop, and your clinical staff gets 35+ hours back per week.

Frequently Asked Questions

Which payers do you handle prior auth for?
All major commercial payers, Medicare Advantage plans, and Medicaid managed care plans. If the payer requires prior auth, we handle it.
How quickly can you submit an auth?
Most authorizations are submitted within 24 hours of receiving the clinical documentation. For urgent cases, we submit same-day.
What if a prior auth is denied?
We appeal immediately with additional clinical documentation. Our team knows what each payer needs to overturn a denial, and we escalate when necessary.
Do you handle phone-based authorizations?
Yes. For payers that still require phone-based auth (and many do), our team handles the calls. Your staff never has to sit on hold again.
Can you handle surgical prior authorizations?
Yes. Surgical and high-cost procedure authorizations are our specialty. We ensure all documentation, medical necessity, and clinical criteria are included upfront.

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