A Missing Authorization Isn't a Small Detail, It's a Denied Claim
Every procedure scheduled without the right authorization in place puts revenue at risk before the patient even walks in. Left unchecked, missing approvals delay care, frustrate patients, and turn an otherwise clean claim into an automatic denial.
We check requirements before a service is scheduled, submit requests with the documentation payers expect, and follow up until an answer comes back, so authorization is never the reason a claim falls through.
- Delayed Procedures Waiting on Approval
- Missed Payer-Specific Requirements
- Staff Overwhelmed by Payer Calls
- No Tracking on Pending Requests
Are These Prior Authorization Challenges Affecting Your Practice?
Stop Losing Time to Authorization Delays
Complete Solutions for Every Stage of Authorization
Authorization Requirement Checks
- Payer Requirement Verification
- Plan-Specific Rule Checks
- Pre-Scheduling Review
- Service Eligibility Screening
Request Submission & Documentation
- Clinical Documentation Preparation
- Request Form Completion
- Accurate Payer Submission
- Medical Necessity Support
Status Tracking & Follow-Up
- Request Status Monitoring
- Delay Escalation
- Direct Payer Follow-Up
- Turnaround Time Tracking
Denial & Appeal Support
- Denial Review
- Peer-to-Peer Coordination
- Resubmission Follow-Up
- Appeal Preparation
Urgent & Same-Day Requests
- Expedited Request Handling
- Priority Flagging
- Rapid Payer Follow-Up
- Same-Day Coordination
Reporting & Approval Tracking
- Approval Rate Reporting
- Turnaround Time Tracking
- Payer Performance Analysis
- Regular Status Updates
How We Handle Your Prior Authorizations
We build the process around your scheduling workflow, so authorization gets handled before a service date arrives, not after.
Requirement Check
We confirm whether a scheduled service requires authorization under the patient’s specific plan.
Request Submission
We submit the request with supporting documentation, matched to what the payer requires.
Status Follow-Up
We track pending requests and follow up directly with payers that haven’t responded.
Denial Response
We review and appeal denied requests with additional documentation where warranted.
Approval Confirmation
We confirm and log the authorization before the service date, so billing isn’t at risk later.
Why PMBC Simplifies Prior Authorization
Certified coders trained across multiple specialties
Claims scrubbed and submitted within 24 to 48 hours of service
Real time reporting on claim status, denials, and collections
Dedicated account manager who knows your practice
AI-powered workflow automation for faster, more accurate billing
Reduced FTE costs with transparent, no-hidden-fee pricing
PMBC vs. the alternatives
Actionable Insights for Better Patient Collection
What Our Customers Are Saying
Ammar Alobaidy, MD
Practice Administrator
Pankaj Jain, MD.
Habib U. Khan, MD
FAQ
01. What's the difference between medical billing and medical coding?
Coding translates clinical documentation into standardized codes that describe the diagnosis and services provided. Billing takes those codes and turns them into a claim that gets submitted to the payer for payment. They’re separate steps, but they need to be accurate together for a claim to get paid correctly.
02. How do you make sure claims are coded correctly?
Every claim is coded against current documentation and reviewed before submission. Our staff stays current on coding updates as they’re released, since a code that was valid last year can trigger a denial today if it hasn’t been updated.
03. How long does it take to get a claim submitted after a visit?
Claims are typically submitted within a few business days of the visit, once documentation and coding are complete. We don’t let claims sit in a queue, since faster submission generally means faster payment.
04. What happens if a claim is rejected before it's even submitted to the payer?
A rejected claim, one that never reaches the payer due to a formatting or data error, gets corrected and resubmitted right away. Catching these early means they don’t count against your denial rate with the payer.