Prior Authorization Services

Have you ever considered outsourcing your Pre-Authorizations?  Outsourcing your Pre-Authorizations would benefit your office tremendously!  The insurance verification and pre-authorization process is essential to every practice’s bottom line. Outlining the patient benefits and coverage for specific medical procedures before the service is the most important step to ensure a successful practice. Pre-authorization or prior approval is necessary to acquire reimbursement for many non-urgent medical procedures and services. Failing to obtain this information could subject your practice to delayed payments, the need for claim rework and resubmission, errors, nonpayment and more. Burks Medical Consulting, LLC can help you verify whether or not a particular medical procedure is covered as well as obtain prior approval from payers when necessary. This will ensure timely and appropriate reimbursement.  By ensuring that all scans have Prior Authorizations, we are confident that we can increase your revenue and free up your office staff to concentrate on the patients!

Our experienced Prior Authorization Coordinators will call insurance companies and get authorizations in the most efficient manner. As a leading insurance authorization company, we work with all government and private insurances such as BCBS (all states), Cigna, Humana, Medicare Advantage Plans, Medicaid, Meritain, FirstChoice Select, Healthnet, MagnaCare, TX Healthsprings, UMR, Clover, GEHA, Wellcare, Wellmed, Health Alliance, AmeriHealth, Workers’ compensation(all states), Aetna, UnitedHealthcare, Oxford & many more.  Our team also works on insurance website portals to gather information and apply for authorizations.

We provide services for a variety of specialties to include:

• Radiology
• MRI/CT
• Nuclear Medicine
• Injections
• Physical Therapy
• Orthopedics
• Oncology
• Obstetrics and Gynecology
• Chiropractic
• Physical Medicine and Rehab
• Surgery
• Sleep Medicine
• And Many More………

Outsourcing your Pre-Authorizations would have a cost-effective alternative to reduce overhead costs, reduce you’re A/R cycle, increase your income & streamline your revenue flow.  You would eliminate a high turnover, employment cost for recruiting, training, and sustaining employees in your office and high cost of employee benefits.   We are a company that can give your office the special attention and dedication that it needs.   We will work hard for YOU!!

Benefits for Hospitals

For hospital clients, BMC manages the difficult and costly work associated with coordinating care among the hospital, payers and patients. This new service delivers more control and cuts down on busywork by eliminating unnecessary redundancies.  BMC handles cumbersome tasks on behalf of clients, creating workflow efficiencies and freeing up staff time and resources.  Hospitals see:

• More revenue from reduced denials, higher procedure volume and increased up-front (or Point-of-Service) collection of self-pay balances.
• Faster revenue from fewer delays in payment, elimination of lost orders and pre-appointment patient collections
• Greater control and reduced workload
• Improved patient satisfaction due to a streamlined Prior Authorization process

Benefits for Practices

With this service, physician practices can spend less time managing outbound orders, obtaining pre-authorizations  and following up with clinical documentation. They also get much better visibility on the status of the patients they have sent to the receiving facility. Spending less time on these tasks frees-up providers to focus their efforts on patient care.

BMC comprises a key service component:

Pre-certification — A dedicated team of specialists with clinical and payer knowledge verifies eligibility and benefits. They also obtain the required insurance pre-certifications to ensure claims get paid the first time.