Prior Authorization Services
Our managed team gathers records, completes payer forms, submits provider-approved authorization requests and tracks their status. Behavioral-health paperwork, psychiatric requests and other specialty submissions follow the provider decisions already made. A shared log shows what was submitted, what the payer requested next and which items need your team's approval.
Prior Auth Challenges We Solve
Hours Lost on Hold
Prior auth calls can take 30+ minutes each. Multiply that by dozens per week.
Denied Authorizations
Incomplete submissions and missed requirements lead to denials and delays in care.
Constant Follow-Up
Tracking pending auths, following up on decisions, and handling appeals is exhausting.
Complex Requirements
Every payer has different forms, criteria, and processes. It's hard to keep up.
What we handle
Administrative authorization support from approved request to recorded payer response.
- Check payer-reported authorization requirements for the requested service.
- Collect the order and supporting records supplied by your provider.
- Complete administrative fields on payer-specific forms.
- Submit the provider-approved request through an authorized channel.
- Record submission dates, references and confirmation of receipt.
- Track pending requests and payer responses in a shared log.
- Gather additional documents requested by the payer.
- Route questions requiring provider input to the designated contact.
- Coordinate provider availability for requested peer-to-peer calls.
- Prepare approved appeal packets and track their submission status.
Prior Authorization Package
Starting at 40 hours per month. Track provider-approved submissions and payer responses.
Book Discovery CallHow it works with your practice
The Team Lead learns how providers send requests, where approved records live and who signs or reviews each submission. Those steps become written and video SOPs you keep. The Primary MVA prepares and tracks requests; the Backup MVA learns the same payer channels, document checklist and handoff rules. Work occurs inside your EHR, practice-management system, payer portals and phone system with the permissions you approve.
Agree on reporting around pending requests: submitted items, missing records, payer questions, scheduled provider calls and recorded determinations. Keep requests open until the next action has an owner, not merely until a form has been sent. Your practice identifies priority requests and the procedure for escalating administrative deadlines. Payer decision times remain outside the assistant's control.
Who it's for
Mental health clinics and PMHNP practices can define behavioral-health prior authorization paperwork around provider-approved requests. Multi-provider groups can centralize tracking while preserving separate approval contacts and specialty-specific document requirements.
Mental health clinics, PMHNP practices and group practices.
What stays with your team
Your providers decide what to order and sign the supporting documentation. We gather records, complete forms, submit approved requests and track the next administrative step.
Security and HIPAA
Our HIPAA-trained team works through HIPAA-compliant processes, with a BAA with every client. Your practice authorizes system access and defines permitted actions before work begins. Review our security and compliance information when planning access and communication rules.
Medical virtual assistant services can connect this function to your broader administrative workflow.
Read Prior Authorization Virtual Assistants: How a Managed Team Speeds Approvals for a closer look at paperwork preparation and provider handoffs.
Frequently Asked Questions
Get answers to common questions about this service.
Related services
View all servicesHelpful Articles
Explore administrative workflows, preparation steps and practice-owner questions for this service.
Prior Authorization Virtual Assistants: How a Managed Team Speeds Approvals
Learn how managed teams of medically trained professionals organize prior authorizations, follow up with payers, and route clinical decisions to your providers.
Read More of Prior Authorization Virtual Assistants: How a Managed Team Speeds ApprovalsPrior Authorization Bottlenecks: A Practice Owner's Playbook
Prior auths consume 14 physician hours/week on average (AMA 2024). Here's how to delegate, automate, and escalate, without sacrificing approval rates.
Read More of Prior Authorization Bottlenecks: A Practice Owner's Playbook
Insurance Verification: A Practice Guide
How trained virtual assistants streamline insurance verification processes to save time, reduce claim denials, and improve patient satisfaction.
Read More of Insurance Verification: A Practice GuideReady to Streamline Prior Authorizations?
Let our team handle the prior auth burden so you can focus on patient care.
Virtual Nurse Rx provides fully managed medical administrative support through a U.S.-based team of registered nurses, with a dedicated Primary MVA, a guaranteed weekly Backup MVA, a Team Lead and a Practice Success Coach.
This is general information, not legal advice.
For medical emergencies, callers are instructed to hang up and dial 911.
Administrative support only; clinical decisions remain with your licensed providers.