Prior Authorization Services
Your Nurses Should Be With Patients. Not on Hold with Payers.
Prior authorization pulls clinical staff away from patient care and into phone queues, fax machines, and payer portals. Payers don't reimburse unauthorized services — no exceptions. KeyMed Partners obtains, tracks, and manages prior authorizations so your team stays clinical and your high-value claims stay protected.
One Full-Time Employee, Just for Permission Slips
The AMA reports that practices spend an average of 45 hours per week on prior authorization — more than one full-time employee dedicated to obtaining permission to provide care. Eighty-five percent of commercial payers require it, and the list of services keeps growing. When an authorization falls through the cracks — because staff was overwhelmed, the fax was lost, or the turnaround window closed — the claim is denied outright. No appeal. No rework. Just lost revenue on a service you already provided. And with over 50% of denials never refiled, most authorization failures become permanent losses.
Full-Service Authorization Management
We handle the entire prior auth lifecycle — from identifying which services need authorization to obtaining approval and confirming it before the service is scheduled. Your team is notified when it's approved. That's their only touchpoint.
Clinical Documentation Support
We know what clinical documentation each payer requires for each service category. We prepare the submission package so your clinical staff only needs to review and sign — not research and compile.
Status Tracking and Payer Follow-Up
Every authorization is tracked from submission to decision. Our team follows up on pending requests daily and responds to payer information requests the same day. We don't wait for callbacks, and we don't let requests sit in queue.
High-Value Claim Protection
We prioritize authorization by claim value and complexity. Your highest-revenue services — surgeries, advanced imaging, specialty drugs — get the most thorough attention and the earliest submission. If authorization is denied, we appeal immediately.
45 hrs/wk
Average Prior Auth Burden
The AMA reports practices spend 45 hours per week on prior authorization. KeyMed Partners takes that entire workload off your staff.
85%
Of Payers Require Pre-Auth
The vast majority of commercial payers require prior authorization for certain procedures. Missing even one means a denied claim on a service already provided.
30-50%
Denial Reduction
Our clients see 30-50% fewer denials overall, with some of the most significant improvements coming from prior authorization management.