Insurance authorization is a critical step in the revenue cycle, ensuring services are covered before they are rendered. AllegianceRCM streamlines prior authorizations with fast approvals, reduced denials, and enhanced compliance, allowing healthcare providers to focus on patient care while maximizing reimbursement potential.
Prior authorization is a payer-mandated approval process that determines coverage eligibility before medical services are performed. Failure to secure authorizations can result in claim denials, revenue loss, and financial burdens on both providers and patients. AllegianceRCM ensures a proactive, compliant, and efficient authorization process that reduces administrative workload and accelerates payment cycles.
How We Help You Succeed.
AllegianceRCM delivers end-to-end authorization services, ensuring a hassle-free, streamlined process from request submission to approval confirmation. Our team works directly with payers, handling the complexities of insurance verification and prior authorizations with precision and efficiency.
We conduct thorough insurance checks to verify patient coverage, co-pays, deductibles, and plan limitations before authorization submission, reducing claim denials and ensuring a smoother reimbursement process.
Our team secures timely approvals for scheduled medical services, surgeries, and specialized treatments, ensuring compliance with payer requirements and minimizing delays in patient care.
We manage real-time authorization approvals for ongoing hospital stays, extended therapies, and multi-session treatments, ensuring continuous patient coverage and reducing billing complications.
For urgent and emergency cases, we handle post-treatment approval requests, compiling necessary documentation to help providers secure reimbursement even when prior authorization wasn’t feasible.
We proactively track, appeal, and resolve denied authorizations by providing accurate documentation, negotiating with payers, and ensuring timely reconsiderations to prevent revenue loss.
Navigating prior authorization can be complex and time-consuming. Inconsistent payer policies, evolving regulations, and delays in approvals can create bottlenecks in healthcare administration. AllegianceRCM mitigates these challenges with a proactive, tech-driven approach.
With expertise in payer policies, AI-driven automation, and a dedicated team of RCM specialists, AllegianceRCM ensures a fast, compliant, and error-free authorization process that optimizes financial outcomes for healthcare providers.
Our comprehensive approach covers everything from insurance discovery and verification to prior authorizations and benefits validation. We ensure every patient’s coverage details are accurately confirmed before services, reducing denials and improving payment efficiency for healthcare providers.
Utilizing artificial intelligence and robotic process automation (RPA), our system eliminates manual errors and speeds up verification processes. We provide real-time eligibility checks, automated workflows, and instant payer responses, ensuring faster claim approvals and revenue optimization.
Our eligibility verification system seamlessly connects with leading EHR, PMS, and billing platforms, allowing instant access to insurance details, real-time updates, and smooth claim processing. This integration minimizes administrative burden and enhances workflow efficiency.
Our highly trained RCM professionals manage all aspects of payer communication, eligibility checks, and prior authorizations. We proactively resolve coverage issues, compliance discrepancies, and documentation gaps, ensuring fewer claim rejections and maximized reimbursements.
With a track record of reducing eligibility-related denials by 50%, our services ensure faster claim approvals, improved collections, and a better patient experience. We help healthcare providers boost cash flow and maintain financial stability with accurate, timely eligibility verification.
We are technology agnostic and have worked on all modern SaaS based electronic medical records and practice management systems. The following is a list of most common practice management systems used across the industry and extensively used by us. If you don’t see your EHR here, please contact us.
AllegianceRCM is a trusted leader in revenue cycle management, delivering tailored solutions for healthcare providers, including independent practices, specialty groups, and urgent care centers. Our expertise in medical billing, coding, denial management, and credentialing ensures streamlined operations and maximized reimbursements. With a commitment to transparency, cutting-edge technology, and personalized service, we empower providers to focus on patient care while achieving financial success. At AllegianceRCM, your practice’s growth is our priority.
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