Prior Authorization
Authorisation requests started early and followed through to approval, so scheduled procedures aren't delayed — or denied — over a missed step.
Overview
A missed or delayed prior authorisation can push back a scheduled procedure or result in a clean clinical claim being denied for a purely administrative reason. WhiteCoat Ops manages the authorisation process end to end: identifying which services require prior approval, submitting requests with the necessary clinical justification, and following up with payers until a decision is reached.
Where a request is pending or requires additional information, we track it proactively rather than waiting for the payer to reach out, keeping scheduled procedures on track.
Best Suited For
- Specialties with a high volume of procedures requiring prior authorisation
- Practices experiencing scheduling delays tied to pending approvals
- Practices seeing denials linked to missing or expired authorisations
A closer look at this service
Authorisation Requirement Screening
Scheduled services are checked against payer requirements to confirm whether prior authorisation applies.
Request Submission & Tracking
Authorisation requests are submitted with supporting documentation and tracked through to a decision.
Payer Follow-Up
Pending or stalled requests are followed up with the payer proactively to avoid unnecessary delays.
Expiry & Re-Authorisation Tracking
Approved authorisations are tracked for their valid window, with re-authorisation initiated ahead of expiry where needed.
Common questions about this service
How far in advance do you start the authorisation process?
As early as possible once a procedure is scheduled, to allow enough time for payer review and any follow-up before the appointment date.
What happens if an authorisation is denied?
We review the denial reason and, where appropriate, coordinate with your clinical team to submit additional documentation or pursue an appeal.
Often paired with prior authorization
Ready to strengthen your prior authorization?
Tell us about your practice and current process — we'll walk you through how this service fits into your revenue cycle.