HealthPro’s precertification team is responsible for insurance eligibility and benefits, as well as for pre-authorizing procedures to ensure that providers and facilities receive the maximum reimbursements possible.
- Daily reporting of insurance verification, co-insurance & deductible amounts
- Verification of referral requirements
- Verification of patient’s CPT (procedure code) and DX (diagnosis code, ICD10) and confirmation of prior authorization for facilities and physicians
- Authorization information can be directly noted in patient charts
- Maintain daily, weekly, and monthly logs for reconciliation
- In many cases, HealthPro can also get STAT authorizations for last minute appointments, or add-on surgeries