Verify coverage and secure authorizations before the visit
Denials that start at scheduling are the cheapest ones to prevent. We verify benefits, submit and track prior authorizations and give patients a cost estimate before the appointment, so the claim starts clean.
Eligibility and Benefits Verification
We verify coverage at scheduling and again two days before the visit, and flag plan changes, secondary coverage and coordination of benefits issues.
Prior Authorization Submission
We assemble the clinical packet the payer asks for, submit it, and follow up until there is a decision, including units, dates of service and the servicing provider.
Medical Necessity Check
We compare the order and the chart to the payer policy before the request goes out, so gaps are fixed while the physician is still reachable.
Patient Cost Estimates and Financial Clearance
Patients get an out-of-pocket estimate before service. For self-pay and uninsured patients we prepare the good-faith estimate that No Surprises Act rules require.
Authorization Tracking
We track every authorization by date and units used, not just "approved," with an expiration worklist so a visit never lands on an expired auth.
Peer-to-Peer and Denial Handoff
When a request is denied, we schedule the peer-to-peer with the right clinician and route real denials into our denial management workflow.
Patient Billing and Payment Options
Clear statements and easy ways to pay. We work with the payment tools you already use, such as card processing, an online portal or text-to-pay, so you do not have to switch vendors.
Patient Balance Follow-Up
After insurance pays, we send reminders, answer balance questions and set up payment plans that you approve, so patient balances do not age unnoticed.
Payer and service inventory
We list which services need authorization for your top payers, and what each payer wants in the request.
Workflow setup
We connect to your scheduling process so verification and auth requests trigger automatically.
Verification and submissions
Eligibility checks, authorization requests and follow-up run every day.
Status and expiry report
You see what is approved, pending, denied and about to expire.
Denial trend review
We trace remaining denials back to the front end and close the gap.
- Specialties with frequent authorizations such as imaging, infusion, surgery, sleep and behavioral health
- Practices with growing eligibility and self-pay denials
- Practices without a dedicated front-desk verification team
- Groups that need patient estimates for financial clearance
Related reading and services: Denial Management · Prior authorization guide 2026 · Claim denials prevention · Claims Management.
Denials that start at scheduling are the cheapest to prevent
A large share of preventable denials come from the front desk: coverage that lapsed, a service that needed an authorization, a secondary payer nobody asked about. By the time the claim denies, the visit is weeks behind you and the patient has already been treated.
Prior authorization is the sharpest version of this. Starting in 2026, federal rules require many government-program payers to decide standard requests within seven calendar days and expedited ones within 72 hours. That helps, but commercial and employer plans aren't covered the same way, so you still need a tracker that knows the deadline and the visit count, not just the approval.
A denied authorization isn't always the end. A peer-to-peer with the right clinician, backed by a complete clinical packet, turns many of them around. The key is starting it before the visit, not after.
How the front-end workflow runs
- At scheduling: Eligibility checkWe verify coverage and benefits, flag secondary coverage and coordination of benefits, and check whether the service needs an authorization.
- Within days: Authorization requestWe assemble the payer's required clinical packet, submit it and follow up until there's a decision, including units, dates and servicing provider.
- Two days before the visit: Re-verifyCoverage is checked again, because plans change and deductibles reset.
- Before service: Cost estimatePatients receive an out-of-pocket estimate, and self-pay patients get the good-faith estimate that No Surprises Act rules require.
- Ongoing: Track units and expirationEvery authorization is tracked by date and units used, with an expiration worklist so no visit lands on an expired auth.
What front-end access costs
Front-end access and prior authorization is a standalone service, quoted after a short intake. Pricing depends on scheduled volume and how many services need authorization, and it's available without a billing contract.
If you already use us for billing, front-end work pays for itself in fewer denials, and we can quote the two together.
Questions we hear most
What does a prior authorization request need to include?
The order, relevant chart notes, diagnosis and procedure codes, requested units and dates, and the servicing provider. We match the packet to the payer's own policy so it isn't returned for missing information.
What happens when an authorization is denied?
We schedule a peer-to-peer with the right clinician and, if that fails, route it into our denial management workflow for appeal. The clinical team stays involved only where their input matters.
How do you track authorization expiration?
By both date and visit count. An approval for 12 visits that expires in 60 days can lapse either way, so we track both.
Do you provide patient cost estimates?
Yes. Patients get an estimate before the visit, and we prepare the good-faith estimate for self-pay and uninsured patients as required.
Related: Prior authorization guide · Denial management · No Surprises Act billing · Free revenue assessment.
Want to see where your denials start?
We'll trace a sample of recent denials back to scheduling and show you which ones front-end access would have prevented.
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