Prior Authorization
Never Let a Prior Auth Hold Back Patient Care
Prior authorization delays are one of the leading causes of revenue loss and patient dissatisfaction in healthcare. VMC Medone Solutions manages the entire prior authorization process from submission to approval so your team focuses on patients, not paperwork.
THE CHALLENGE
The Challenge.
Prior authorization is one of the most time-consuming and frustrating parts of the healthcare billing process. Physicians spend an average of 14.6 hours per week on prior authorization tasks time that should be spent on patient care.
Denied authorizations, missed deadlines, and incomplete submissions lead to delayed treatments, frustrated patients, and significant revenue loss. VMC Medone Solutions takes complete ownership of your prior authorization workflow ensuring fast approvals, zero missed deadlines, and zero disruption to your practice.
“Prior authorization denials account for over 25% of all initial claim rejections across US healthcare providers.”
How VMC Medone Handles Prior Authorization
Our dedicated team manages every step of the prior authorization process from submission to approval with speed, accuracy, and complete payer compliance.
We handle the complete prior authorization submission process — gathering all required clinical documentation, completing payer-specific forms, and submitting requests through the correct payer channels. Every submission is reviewed for completeness before sending — eliminating rejections caused by missing information or incorrect documentation.
After submission, we proactively follow up with payers to track authorization status, escalate delayed decisions, and ensure timely approvals. Our team monitors all open authorizations daily — so nothing falls through the cracks and your patients never experience unnecessary treatment delays.
When an authorization is denied, we immediately review the decision, identify the reason, and prepare a comprehensive appeal with supporting clinical documentation. Our team submits peer-to-peer review requests when necessary fighting for every authorization your patients need and your practice deserves.
We maintain a complete real-time tracking system for all open, approved, denied, and appealed authorizations updating your practice management system at every stage. Monthly reports give you full visibility into authorization turnaround times, denial rates, and approval outcomes across all payers.
Numbers That Speak for Themselves
Our prior authorization management process delivers faster approvals, fewer denials, and zero care delays — from the very first week of engagement with VMC MedOne Solutions.
Auth Turnaround
Fewer Authorization Denials
HIPAA Compliant
Staff Time Saved Per Week
Our Step-by-Step Prior Authorization Process
A streamlined workflow designed to secure approvals faster and prevent treatment delays.
01.
Service Review
We review scheduled procedures, provider orders, and insurance details to determine authorization requirements.
02.
Requirement Verification
We verify payer-specific guidelines, coverage rules, and authorization criteria before submission.
03.
Documentation Collection
We gather clinical records, physician notes, and supporting documents required by the payer.
04.
Authorization Submission
Authorization requests are submitted through payer portals and approved communication channels.
05.
Status Monitoring & Follow-Up
Our specialists proactively track requests and follow up with payers to avoid processing delays.
06.
Approval & Reporting
We provide authorization updates, approval confirmations, and complete documentation for your records.
What You Can Expect With VMC Medone
When you partner with VMC Medone for eligibility verification — here is exactly what changes in your practice.
Why Choose VMC Medone for
Prior Authorization?
We don't just submit requests — we fight for every approval your patients need.
✅ 48-hour average turnaround on all standard authorization requests.
✅ Peer-to-peer review and appeal support for every denied authorization.
✅ Real-time tracking across all open, approved, and pending requests.
Frequently Asked Questions
Everything you need to know about our eligibility and benefits verification services.
Q2: Which services require prior authorization?
Q4: What happens if prior authorization is denied?
Q6: How quickly can you verify patient eligibility?
Q1: What is prior authorization?
Q3: How long does prior authorization take?
Q6: How do you track authorization status?
What You Can Expect
Faster approvals with zero authorization gaps. Our dedicated prior authorization team ensures every request is submitted correctly the first time, followed up aggressively, and approved on time — eliminating care delays and authorization-related claim denials across all your payers and specialties from day one.
Ready to Get Started?
Schedule your free RCM assessment today. No obligation, no contracts.
RELATED SERVICES
Explore our full suite of end-to-end Revenue Cycle Management services designed to protect and grow your practice revenue.
Eligibility & Benefits Verification
We confirm every patient's insurance coverage, co-pays, and deductibles before every visit — eliminating surprises and preventing denials upfront.
Denial Management, AR & Rejection Handling
We analyze denial trends, correct rejected claims, and pursue every unpaid dollar through systematic AR follow-up and direct payer communication.
Medical Coding Services
Our AAPC/AHIMA-certified coders assign precise CPT, ICD-10, and HCPCS codes — maximizing reimbursement and minimizing audit risk across all specialties.
