Pre Authorization Services

Prior authorization services (Cardiovascular and Interventional Radiology Management and Support Services), are specialized healthcare administrative services designed to streamline and manage the complex process of obtaining approval from insurance companies before certain medical procedures or treatments can be performed.

What are Prior Authorization Services?

Prior authorization services are professional support systems that help healthcare providers obtain necessary approvals from insurance companies before proceeding with specific medical treatments, procedures, or prescriptions. These services are crucial in ensuring that medical care is covered by the patient's insurance, reducing claim denials, and improving the overall efficiency of healthcare delivery.

Benefits of Prior Authorization Services

  1. Reduced Claim Denials: By ensuring proper authorization before procedures, the risk of insurance claim denials is significantly reduced.

  2. Improved Efficiency: Streamlining the authorization process saves time and resources for healthcare providers.

  3. Enhanced Patient Care: Faster approvals mean patients can receive necessary treatments more quickly.

  4. Expertise in Complex Fields: Specialized knowledge in cardiac, vascular, and interventional radiology ensures accurate and efficient handling of complex cases.

  5. 24/7 Accessibility: The digital platform allows for constant access and real-time updates on authorization status.

  6. Personalized Support: Dedicated success managers provide tailored assistance to each healthcare provider.

In conclusion, prior authorization services like those offered by CIMSS play a crucial role in modern healthcare administration. By focusing on specialized areas and leveraging digital technologies, these services help healthcare providers navigate the complex landscape of insurance approvals, ultimately leading to more efficient operations and improved patient care.

CIMSS Innovative Solutions provides prior authorization services

  • CIMSS is a prior authorization expert in the cardiac, vascular and interventional radiology specialties.

  • We set the standard for prior authorization services. cardiac, vascular and interventional radiology specialties.

  • Provide a digitally transformed, Solution as a Service.

    • you can submit, track, follow along and communicate with the team via your secure portal 24x7

    • 24x7 customer service, via any channel of your preference

    • dedicated success manager assigned to your account

  • Provide best of practice, prior authorization services for healthcare providers in the niche areas of interventional radiology and cardiovascular medicine and surgery

  • Main objective is to help medical provider organizations efficiently navigate the challenging prior authorization processes imposed by various payor organizations and improve the overall efficiency of the operations of the medical provider organizations.

  • Our experienced  Clinical operations TEAM, boasting over 25 years of experience in the medical industry, is the backbone of our organization.

  • We use avanced AI systems and have an extensive  knowledge base  of medical necessity guidelines and policies for all insurance companies and payers

  • We offer cost-effective, efficient and digitally transformed solutions, solely focused on cardiac, vascular and interventional radiology specialties.

  • AS experts in this area  we  are able to achieve an impressive 97% approval rate and fast turnaround times.

  • CIMSS delivers comprehensive prior authorization services for out-of-network and in-network providers.

  • We also expertly  handle workers' compensation and motor vehicle accident pre-authorizations

Why should you chose us?

Numerous benefits of our prior authorization services:

  • your organization  can streamline prior authorization processes,

  • reduce administrative burdens, and

  • enhance patient satisfaction.

  • Our team manages the complex and frustrating, busy work of the prior authorization process while  allowing your staff to focus on providing exceptional patient care,

  • At CIMSS Innovative Solutions, we are committed to providing  prior authorization services. cardiac, vascular and interventional radiology specialties across all 50 US states.

The ​​Prior Authorization Process

Coordination of the surgical orders management

  • Review -medical records and conduct Prior-to-insurance eligibility and coverage verification

  • Utilization and medical policy review 

  • Medical necessity evaluation and screening

  • Financial clearance process​​