Prior Authorization Services

Faster Authorizations. Fewer Delays. Better Patient Care.

DI RevNexus manages prior authorization requests end to end — from coverage checks through payer follow-up — so treatment isn't held up waiting on paperwork.

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Turnaround-Focused
Tracked to Approval
Healthcare specialist reviewing prior authorization requests on a dashboard
Authorizations, Tracked From request to approval
Coverage Review
Payer Submission
Faster Approval
01 Prior Authorization Services

Every Authorization, Requested and Tracked.

From the first coverage check to final approval, every authorization is followed through so care isn't delayed by paperwork.

Authorization Requests

Complete, accurate authorization requests submitted promptly for every applicable service.

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Benefits & Coverage Review

Coverage is confirmed and authorization requirements identified before the request is filed.

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Documentation Collection

Clinical documentation is gathered and organized to support a strong, complete request.

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Payer Submission

Requests are submitted through the correct channel for each payer, the first time.

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Authorization Status Tracking

Every pending request is monitored so nothing sits in a payer's queue unnoticed.

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Payer Follow-up

Direct, documented follow-up with payers to move pending decisions forward.

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Denial/Appeal Support

Denied authorizations are reviewed and appealed with the documentation to support them.

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Expiration Monitoring and Reporting

Authorization windows are tracked so renewals happen before coverage lapses.

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How It Works

The Authorization Workflow, Order to Treatment

A structured, trackable path from provider order to completed care.

1

Provider Order

The requested service or procedure is identified from the provider's order.

2

Coverage Check

Benefits are reviewed to confirm whether authorization is required.

3

Documentation

Supporting clinical documentation is gathered to justify the request.

4

Authorization Request

A complete request is submitted to the payer through the correct channel.

5

Payer Review

The request is actively tracked while the payer reviews it.

6

Approval

Approval is confirmed and communicated back to the care team promptly.

7

Treatment

Care proceeds with authorization already in place, avoiding last-minute delays.

8

Follow-up

Authorization windows and any related billing details are monitored after the fact.

Why Choose Us

Why Healthcare Organizations Choose DI RevNexus

A prior authorization team focused on keeping treatment on schedule.

Faster Turnaround

Requests are prepared and submitted quickly, without unnecessary back-and-forth.

Accurate Submissions

Complete, well-documented requests reduce the chance of a request bouncing back.

Proactive Payer Follow-up

Pending requests are followed up with, not left waiting for the payer to respond.

Reduced Delays & Denials

Thorough upfront work reduces avoidable delays and authorization-related denials.

Compliance-Focused Workflows

Authorization workflows built around payer requirements and applicable standards.

Transparent Reporting

Clear visibility into every authorization's status, from request to approval.

Get Authorizations Right. Keep Care Moving.

Let our team review your current authorization process and show you where delays can be eliminated.

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