Prior Authorization

Get Prior Auths Approved Faster
With a Dedicated PA VA

A Prior Authorization VA from HealthSystemVAs submits PA requests, collects required clinical documentation, follows up persistently with payers, and tracks every authorization through to approval — so your providers can treat without delays.

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What Is a Prior Authorization VA?

A Prior Authorization VA from HealthSystemVAs manages the entire prior authorization process for your clinic: submitting PA requests to payers, gathering the clinical documentation required for approval, following up on pending auths, tracking authorization status, and managing denials and appeals — so your billing and clinical staff don't spend hours on hold.

Who This Is For

PT, chiropractic, neurosurgery, and outpatient clinics where delayed or denied prior authorizations are causing treatment delays, revenue delays, or provider schedule disruptions. Ideal for practices with high-volume commercial and Medicare Advantage patients.

Problems This Solves

  • PA requests sitting for days without follow-up
  • High initial denial rates due to incomplete documentation
  • Provider schedules disrupted by pending authorizations
  • Staff too busy to follow up persistently with payers
  • Revenue delayed weeks due to auth backlog
What Your VA Handles

Tasks Your Prior Authorization VA Takes Off Your Plate

PA Submission

Submit prior authorization requests to payers via phone, fax, payer portal, or electronic PA platforms.

Clinical Documentation Gathering

Collect required clinical records, notes, and documentation from your clinical team for PA submission.

Payer Follow-Up

Persistent follow-up calls and portal checks on pending PA requests — daily if needed.

Authorization Tracking

Maintain a real-time PA tracking log with status, auth numbers, and expiration dates in your system.

Denial Management

Document denial reasons, gather additional supporting documentation, and submit peer-to-peer or written appeals.

Expiration Alerts

Track authorization expiration dates and initiate renewal requests proactively before coverage lapses.

EMR / EHR Support

Works With Your Existing Software

Your VA is trained on your specific platform before going live. Supported systems include:

WebPT Kareo AdvancedMD DrChrono athenahealth eClinicalWorks Tebra Jane App Epic Practice Fusion

Using something else? We train your VA on your platform at no extra charge.

KPIs We Track

How We Measure Success

  • PA approval rate (% approved on first submission)
  • Average days to authorization approval
  • Denial rate and denial reason tracking
  • Appeal success rate
  • Authorization backlog (target: cleared within 30 days)
HIPAA Compliance

HIPAA-First, Every Time

Prior authorization processes involve transmitting clinical notes, diagnosis codes, treatment plans, and patient demographics to payers. Your VA follows strict HIPAA protocols — using only encrypted, clinic-approved channels for all transmissions. All documentation is stored in your systems, not retained by the VA on personal devices or external storage.

View our full HIPAA compliance framework →
Implementation

Timeline to Go Live

1
Day 1–3: Free audit, needs scoping, and role definition
2
Day 4–7: Candidate sourcing and profile delivery
3
Day 8–10: You interview and select your VA
4
Day 11–14: EMR training, compliance docs, go-live
FAQ

Common Questions About Prior Authorization VAs

A dedicated PA VA submits requests faster, includes complete documentation on the first submission (reducing initial denials), and follows up persistently. Clinics with high PA denial rates often see improvement within 30–60 days of dedicated PA follow-up, though actual rates depend on payer mix and clinical documentation quality.

Yes. Your VA works with Medicare Advantage plans, commercial payers, workers' comp carriers, and other payers in your specific mix. They learn your top 10–15 payers' PA submission processes during onboarding.

Your clinical staff provides treatment notes, plan of care, and supporting documentation as they do today. Your VA coordinates the collection and submission process — they don't independently create clinical documentation.

View all 35+ FAQ answers →
Get Started

Ready to Delegate Your Prior Authorization?

Book a free 30-minute Clinic Revenue Audit. We'll identify where your clinic is losing revenue and show you exactly how a HIPAA-trained Prior Authorization VA can help — with no obligation.

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