Prior Authorization

We Get Your Approvals—So You Can Focus on Patient Care

Medivantek Billing handles your prior auth requests from start to finish—faster, smarter, and with fewer denials.

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Our End-to-End Prior Authorization Services

Medical Necessity Review and Documentation Collection

We collect and review all required clinical notes and documentation to ensure your request meets the payer’s medical necessity criteria from the start.

Payer Portal Submission or Fax/Call Authorization

Whether it’s online, fax, or phone—we handle all submission methods to get authorizations processed faster and avoid unnecessary delays.

Daily Follow-Up on Pending Requests

Our team follows up with payers every 24 hours to track pending authorizations and expedite approvals.

Real-Time Authorization Status Updates

We keep your team updated with live status notifications so you always know which services are approved, pending, or require further action.

Denial Handling and Re-Submission

If an authorization is denied, we investigate the reason, gather additional documentation, and resubmit promptly to prevent care delays.

Provider and Patient Notifications Upon Approval

We notify both your practice and the patient as soon as authorization is granted—ensuring smoother scheduling and care delivery.

What Is Prior Authorization — And Why It Matters

Prior authorization is your insurance payer’s way of saying, “Hold on — we need to approve this service before it happens.” It’s meant to ensure medical necessity and control costs, but it also creates delays, confusion, and risks for your practice and patients. Without smooth, accurate prior auth, claims get denied, appointments are delayed, and patients get frustrated. You lose revenue and waste precious staff time chasing approvals through complex, ever-changing payer rules.

Why Choose Medivantek

What Makes Prior Auth So Painful?

Delayed approvals that hold up care and invalid authorizations.
Denied claims due to missing authorization
Confusing payer rules and changing forms
Wasted staff hours on hold or in portals
Disrupted scheduling and patient dissatisfaction
Weeks-long delays that stall patient care and scheduling
Delayed approvals and invalid authorizations

How Medivantek Medical Billing Solves the Prior Auth Problem

All required clinical info is gathered and submitted correctly
Payer-specific forms and submission portals are handled efficiently
Submission via all payer portals, fax, and direct calls — we pick the fastest channel
Prioritization of urgent and STAT authorizations
Follow-ups are completed on time
Denied auths are ( investigation) appealed with supporting documentation

Specialties We Cover for Prior Auth

We maintain an up-to-date, comprehensive list of all CPT and HCPCS codes that require prior authorization across specialties — ensuring nothing slips through the cracks. Our deep payer knowledge means your requests are accurate and complete every time.

We manage prior authorizations for:

Diagnostic Imaging (MRI, CT, PET)
DME & Orthotics
Behavioral & Mental Health Sessions
Pain Management & Injections
Cardiology & Sleep Studies
Surgical Procedures
Lab & Genetic Testing
Spec Coding Medivantek

EMR/EHR & Portal Integration

We use and integrate with all major systems, including:

  • Availity
  • CoverMyMeds
  • Navinet
  • Kareo
  • Athenahealth
  • NextGen
  • AdvancedMD
  • eClinicalWorks

Don’t Let Delays Block Your Patient Care

One missed prior authorization can lead to denied claims, delayed treatments, and patient frustration. Let Medivantek billing handle the complex, time-consuming prior auth process—with payer-specific precision, consistent follow-ups, and fast approvals that keep your care plans on track.

Get Started with Prior Authorization Services

Frequently Asked
Questions (FAQs)

Yes. Our team handles all communication—portal submissions, faxing, and live phone calls—to ensure nothing falls through the cracks.

Absolutely. We specialize in fast-tracking urgent requests and immediately notifying you once approved—keeping time-sensitive treatments on schedule.

We support secure fax, encrypted email, and EHR/PMS integrations—making it easy to collaborate without disrupting your current workflow.

We handle the entire denial management process, including gathering supporting documentation, writing appeals, and resubmitting until approved.

You’ll receive daily or real-time updates via email, shared drives, or directly in your PM system—complete with a full audit trail for compliance.

Yes. We regularly process mental and behavioral health PA requests, including therapy sessions, psychological testing, and medication approvals.

We’re ready to go within 2–3 business days after onboarding. Once provider details are received, we begin processing your authorizations right away.
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