Comprehensive pre-billing services

Authorizations and Eligibility Services

Ensuring that patients have proper authorization and eligibility for services provided is crucial for both providing quality care and maximizing revenue. At ARCM, we offer comprehensive pre-billing services focussed on authorization and eligibility to ensure reimbursement for the patients you admit.

Our Services:

Eligibility Verification

Verifying patient eligibility is essential for ensuring that services rendered are covered by insurance and will be reimbursed. ARCM performs thorough initial and ongoing eligibility checks, confirming insurance coverage, coverage limits, deductibles, and co-pays to prevent denials and avoid billing issues.

Prior Authorization Support

Prior authorizations are often required for covered services. ARCM assists healthcare providers in obtaining prior authorizations from insurance payers, navigating complex requirements, and advocating for timely approvals to avoid delays in patient care.

Authorization Management

ARCM helps healthcare providers navigate the complex world of authorizations, obtaining necessary approvals and re-authorizations from insurance payers for their relevant services. Our team manages the entire authorization process, from submission to follow-up, ensuring timely approvals and reducing delays in patient care.

Appeals Management

In cases where authorizations are denied or eligibility is disputed, ARCM provides comprehensive appeals management services. Our team reviews denial reasons, and submits appeals on behalf of providers, maximizing chances of approval and ensuring proper reimbursement.

Why Choose ARCM for Authorizations and Eligibility:

Expertise: Our team consists of experienced professionals with in-depth knowledge of authorization and eligibility processes across all insurance payers.
Compliance: We stay up-to-date with payer policies and regulations to ensure that authorization and eligibility processes are compliant with each payer.
Efficiency: We leverage technology and streamlined workflows to expedite authorization and eligibility processes, reducing administrative burden and improving efficiency.
Patient Care: Our services help streamline administrative tasks, allowing providers to focus more on delivering quality care to their patients without disruptions.
Revenue Optimization: By ensuring proper authorizations and eligibility, we help minimize denials, reduce revenue leakage, and optimize reimbursement for healthcare providers.

Partner with ARCM for Authorizations and Eligibility Services

Contact us today to learn more about how our authorization and eligibility services can benefit your organization and streamline your revenue cycle management processes.

Let us help you navigate the complexities of insurance authorizations and eligibility, so you can focus on providing exceptional care to your patients.