Eliminate Delays. Secure Approvals. Focus on Patient Care.
Navigating the prior authorization (PA) process is one of the most time-consuming yet essential administrative tasks in healthcare. Many procedures, tests, medications, and services now require payer approval before care can be delivered or billed. Unfortunately, the complexity of these requirements often causes delays, denials, and revenue loss.
At Pristinesolutions , we take the burden off your staff by handling every step of the prior authorization process—from checking requirements and preparing documentation to follow-up and appeal. Our experienced team ensures your authorizations are submitted quickly and correctly—so your patients get the care they need without unnecessary delays.
Why Prior Authorization is Crucial
Prior authorization protects insurance companies against unnecessary costs—but it puts a heavy administrative load on providers. Without proper PA, you risk:
- Delayed treatments and rescheduled appointments
- Claim denials and lost revenue
- Poor patient satisfaction due to long wait times
- Increased administrative overhead for your staff
What We Offer
PA Requirement
Verification
We confirm whether a prior authorization is required based on CPT/HCPCS codes, service type, provider specialty, and payer-specific rules.
Clinical
Documentation Review
Our team collects and prepares the necessary clinical notes, prescriptions, imaging orders, or treatment plans to meet payer requirements.
Submission
to Payers
We submit PA requests using the correct channel—payer portals, secure fax, or direct phone—depending on payer preferences and urgency.
Real-Time Tracking
& Follow-Up
We actively monitor and follow up with payers on outstanding requests, ensuring nothing falls through the cracks.
Appeals &
Resubmissions
If a request is denied, we prepare and submit appeals or additional documentation to overturn the decision quickly and professionally.
Status Updates
& Reporting
We keep your staff informed at every step, with real-time updates and reporting to keep operations smooth and transparent.
Services & Specialties We Support
Our team handles prior authorizations across a wide range of clinical specialties and services, including:
- Radiology (MRI, CT, PET scans)
- Surgical procedures
- Behavioral health (therapy, psychiatric services, IOP, PHP)
- Specialty medications and injectables
- Durable Medical Equipment (DME)
- Home health and hospice
- Therapy services (PT, OT, ST)
- Telehealth services requiring payer approval
Why Choose Pristonsolutions
Trained PA
Specialists
Skilled in payer-specific rules and documentation.
Faster
Approvals
Reduce wait times and avoid care delays.
Improved
Revenue Cycle
Lower your denial rate and boost clean claims.
Fully
Managed Process
We keep you informed with regular status updates and alerts for renewals or expirations.
Affordable
Plans
Flexible pricing and packages to suit individual providers, growing practices, and large groups.
Trusted Partners
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