Front-End Defense

Front-Office Intake, Prior Auth & Healthcare BPO

Fix Clean Claims Where They Start: Real-Time Eligibility & Prior Auth Clearing

Over 80% of claim denials originate at the front desk: invalid policy IDs, unverified deductibles, expired coverage, and unobtained prior authorizations. Our specialized healthcare front-office team secures pre-authorizations and verifies benefits before patients walk through the door.

Request Free 10-Claim Denial Audit (209) 671-6993

Performance Commitments

Prior Auth Approval Rate

97.6%

Intake Eligibility Verification

100% Pre-Visit

Front-End Denial Reduction

89%

100% HIPAA CompliantMutual BAA Executed

AAPC & AHIMA CertifiedCPC, CPMA & CCS Coders

SOC-2 Type II AlignedEncrypted EDI Gateways

CMS & OIG StandardsCMS-1500 & UB-04 Audits

Zero Migration Needed • Direct In-EHR Operations:

AthenaHealthEpic SystemseClinicalWorksKareo / TebraAdvancedMDModMedNextGenDrChrono

Problems We Eliminate

Common Practice Bottlenecks Solved

Front desk staff overwhelmed by patient check-in and phone calls, skipping thorough insurance checks

Expensive surgical or diagnostic procedures performed without required prior authorizations

Patients blindsided by high out-of-pocket costs due to unverified high-deductible health plans (HDHPs)

Clinical staff spending 15+ hours weekly on hold with insurance companies for pre-approvals

Scope of Work

Key Deliverables & Standard Operating Procedures

24/48-Hour Pre-Encounter Eligibility & Detailed Benefit Verification (copay, coinsurance, remaining deductible)

Dedicated Prior Authorization submission through CoverMyMeds, Availity, eviCore, AIM, and payer portals

Coordination of peer-to-peer physician reviews with compiled clinical chart packets

Patient estimation statements and pre-service co-pay/deductible collection guidance

Medical transcription and remote virtual scribing assistance to free up physician charting time

Systematic Execution

Our 4-Step Operational Workflow

Daily Schedule Pull

Our team accesses your schedule 48-72 hours in advance to run comprehensive 270/271 eligibility inquiries.

Benefit Matrix Breakdown

Documenting exact patient financial liability, active primary/secondary status, and specific procedure coverage.

Prior Auth Submission

Uploading clinical notes, diagnostic imaging, and letters of medical necessity into payer authorization portals.

Approval Tracking & Integration

Entering the authorization number, approved CPT codes, and validity dates directly into your EHR scheduling system.

Frequently Asked Questions

Can your team handle urgent same-day prior authorizations?

Yes. When an urgent prescription or emergent diagnostic procedure is ordered, our team marks it STAT and manages immediate phone and web portal escalation.

How does this coordinate with our existing front-desk staff?

We operate as an extension of your front office. We do the heavy background lifting (hours spent on hold with payers and logging authorizations), so your in-office staff can focus 100% on greeting patients and clinic flow.

Zero Risk • Mutual BAA Signed First

Ready to Upgrade Your Practice’s Front Office & Prior Auth?

Take the risk-free first step with our Free 10-Claim Denial Audit. We pinpoint the exact leaks in your current billing workflow within 48 business hours.

Speak directly with an RCM Director:

(209) 671-6993

100% Risk-Free B2B Evaluation

Request Your Free 10-Claim Audit for Front Office & Prior Auth

Zero upfront cost. We sign a HIPAA BAA before examining any documentation.