Referrals and Authorization

We manage both referrals and authorization processes to ensure that patients have the necessary documentation before their appointments. Our team handles both paper and electronic referrals, working closely with patients’ primary care providers and adhering to insurance company protocols.

Our referrals and authorization services include the following:

• Referral Processing: For insurances that require referrals, we process both paper and electronic referrals by contacting the patient’s primary care provider or doctor to confirm that the referral is on file before the scheduled appointment.
• Authorization Preparation: We prepare and process authorizations based on referrals/orders or as requested by the clinic, ensuring compliance with insurance company protocols.
• Protocol Adherence: We strictly follow the specific guidelines provided by each insurance company to guarantee accurate processing and minimize potential denial of claims.
• Timely Coordination: We proactively handle referral and authorization requirements ahead of appointments, reducing the risk of rescheduling/cancellations and denial of claims.

Our Standard Operating Procedures (SOP) and process flow are tailored to match the specific protocols of our partner clinics. During the initial training and orientation, we develop a comprehensive knowledge base and cheatsheets, which are submitted for approval to ensure accuracy and consistency throughout the referral and authorization process.