Stop losing revenue to missed authorizations.
We specialize in surgical and imaging prior authorizations — our specialists manage your payer requests from intake to decision, so your staff stops chasing deadlines, denials go down, and patients get care on schedule.
We don't just process authorizations — we keep your team informed on the health of your authorization workflow, using the data from every case to track payer-mix trends (which payers routinely deny, and why) and flag the documentation and policy gaps driving those denials.
Fewer missed deadlines. Faster approvals. Less time on hold with payers.
Sound familiar?
“We found out an authorization had expired after the patient was already in the chair.”
Surgery scheduler
“Our front desk spends hours a week on payer portals and hold music instead of patients.”
Practice manager
“A denial came back for missing documentation nobody flagged in time to appeal.”
Billing lead
What you get when we manage your prior authorizations
A dedicated specialist team watching every deadline, every payer, every case — so you don't have to.
No More Missed Deadlines
Every payer, every state, every rule is tracked independently. Nothing falls through the cracks because a deadline was buried in an inbox.
Protected Revenue
Fewer denials and faster turnarounds mean fewer delayed procedures, fewer write-offs, and a healthier bottom line.
Hours Back for Your Staff
Your team stops spending their day on payer portals and hold queues. We handle the submissions, follow-ups, and appeals.
Fewer Denials, Faster Appeals
We know what documentation each payer needs up front, and act immediately when a denial or peer-to-peer review is requested.
Workflow Health Visibility
We keep your team informed on the health of your authorization workflow — not just individual case status, but how the process as a whole is performing.
Payer Mix & Denial Trend Tracking
We use the data from every authorization we process to track payer-mix trends, surfacing which payers are routinely denying and why — so patterns get fixed, not just individual denials.
Documentation & Policy Tracking
Our documentation and policy trackers pinpoint exactly where gaps in paperwork or payer-policy understanding are leading to routine denials, so the root cause gets addressed, not just the symptom.
Clear Reporting
Regular reporting on approval rates, turnaround times, and outstanding cases — so you always know where things stand.
Compliance First, Always
Strict data handling and access controls protect patient information at every step of the process.
A simple handoff. We do the work, you see the results.
Your specialties, payers, and workflows — so our team fits right into how you already operate.
A quick referral through the client portal, and our specialists take it from there.
Submissions, follow-ups, documentation requests, and appeals — handled by people who know each payer.
A clear decision, delivered on time, with visibility into every step.
Behind the scenes, our specialists use InspiredAuth, our case management workspace, to keep every request, deadline, and payer conversation organized. Clients can see their own requests in the client portal.
End-to-end authorization support.
Specialized in surgical and imaging authorizations. Each engagement is scoped to your volume, specialties, and payer mix.
- Insurance eligibility and benefits verification
- Payer-specific documentation checklists before submission
- Submission through payer portals, phone, and fax
- Status follow-up until a decision is received
- Peer-to-peer scheduling and appeal preparation
- Expiration and visit-count tracking for approved authorizations
- Ongoing visibility into the health of your authorization workflow
- Payer-mix trend tracking — which payers are routinely denying, and why
- Documentation and policy trackers that pinpoint where gaps are driving denials
- Monthly reporting on approvals, denials, and turnaround
We connect to the EHR you already use
Read-only data sync into InspiredAuth — so your team tracks every authorization in one place — is included as part of a standard engagement setup. If you also want authorization status and documents written back into your own EMR chart, that's a scoped add-on.
eClinicalWorks (eCW)
Write-back into the chart is available as a scoped add-on.
Your organization authorizes our access directly, self-service, from within your own eCW instance.
NextGen Enterprise
Write-back is available as a scoped add-on under NextGen’s terms.
Your organization grants access directly, self-service, from NextGen’s own API Client Portal.
NextGen Office
Read-only is the integration NextGen Office supports.
NextGen coordinates onboarding for your practice directly; we’ll confirm timeline and any vendor-side requirements as part of your proposal.
Epic
Write-back is available as a scoped add-on, coordinated under your health system’s own Epic credentialing process.
Access runs through your health system’s own existing Epic relationship — we’re credentialed as an API user under your organization’s agreement with Epic, not through an instant self-service click-through. We’ll confirm timeline as part of your proposal.
Modernizing Medicine (ModMed)
Read-only is the integration currently supported for ModMed.
ModMed coordinates onboarding for your practice directly through their own partner review process rather than an instant self-service connection; we’ll confirm timeline and requirements as part of your proposal.
Every EHR connection is set up per client — your organization authorizes our access to your own instance, it's never automatic. We'll confirm compatibility and scope the connection (and any write-back add-on) as part of your proposal. Don't see your EHR listed? Ask us.
Estimate pricing for our prior-authorization specialists
Healthcare Inspired's own specialists manage your payer submissions end to end — this is a fully managed service, not software you license or staff yourself. Pricing is based on the physicians you need covered and your monthly authorization volume by complexity — never a per-seat or per-user fee.
Covers account management, eligibility & benefits verification, and standard reporting for your panel — independent of month-to-month volume swings.
Monthly completed authorizations, by complexity
Each complexity tier is priced against typical reimbursement for that category, so the fee always stays a reasonable, defensible percentage of the value it protects — never a flat rate that risks costing more than a service is worth.
Durable medical equipment (DME) authorizations — high transaction volume, little or no attached physician reimbursement. Priced against realistic cost-to-serve and in-house staff-time savings, not a reimbursement ratio.
No meaningful attached reimbursement for most DME authorizations — priced to beat typical in-house processing cost ($11–$90/transaction per published industry research), not as a percentage of a payment.
Diagnostic imaging authorizations — single-step payer review, lower documentation burden.
Typically ~13–19% of a $150–$220 imaging reimbursement.
ASC & hospital outpatient procedures, pain/spine/MSK, cardiology & cardiac testing, therapy & rehab, and home health — multi-step documentation and follow-up.
Typically ~4–12% of a $500–$1,500 reimbursement.
Major surgery, behavioral health, and inpatient/concurrent review — highest documentation burden. Any case requiring peer-to-peer review or a formal appeal is billed at this tier regardless of originating specialty.
Typically under ~11% of a $1,100–$5,000+ professional fee.
Estimated monthly total
This is a non-binding planning estimate only, not an invoice. A services engagement always requires a scoping conversation (payer mix, actual volume, submission channels, SLAs) before a final price is set.
Request authorization services
This is a request for Healthcare Inspired's prior-authorization consulting services (our specialists managing your payer submissions) — not a software purchase. Your estimate above will be included so our team can follow up with a scoped proposal.
Built for the teams we consult with
We specialize in surgical and imaging prior authorizations — Healthcare Inspired's independent consultants bring coding, billing, auditing, credentialing, compliance, and education expertise to:
Physician groups and specialty clinics with high volumes of imaging, procedures, and injections.
Outpatient departments and service lines that depend on timely payer decisions.
Surgical schedules that can’t wait on late or missing authorizations.
Front desk and scheduling staff who need authorizations handled before the visit.
Protect your revenue and give your team their time back.
Healthcare Inspired brings together independent consultants in coding, billing, auditing, credentialing, compliance, revenue cycle optimization, and provider education — plus virtual events, workshops, and healthcare education experiences that keep your team sharp.