Prior Authorization

Still Have More Questions?

Contact Our Support Team.

Accelerate Approvals, Eliminate Treatment Delays

Medi Flows Billing Solutions delivers end-to-end prior authorization services that fast-track insurer approvals, prevent claim denials, and keep your patients on track for timely treatment. Our dedicated team manages the entire authorization lifecycle—from eligibility verification and clinical documentation collection to submission, follow-up, and appeals—so your providers never face unexpected denials or delayed care.

For over 20 years, Medi Flows has delivered trusted administrative support across the USA.

Medi Flows combines clinical expertise with deep payer protocol knowledge to secure approvals faster. We integrate seamlessly with your EHR and workflows to eliminate administrative bottlenecks—transforming prior authorization from a revenue blocker into a streamlined, predictable process that protects both patient care and your bottom line.

Eligibility Verification & Benefit Analysis

We confirm patient coverage, identify authorization requirements by payer and procedure code, and determine medical necessity criteria before services are rendered—preventing retroactive denials.

Clinical Documentation Collection & Review

Our clinical team collaborates with your providers to gather, organize, and validate supporting documentation (progress notes, imaging reports, lab results) to build compelling, audit-ready authorization packages.

Authorization Submission & Payer Liaison

Accurate completion and electronic submission of payer-specific forms to commercial insurers, Medicare Advantage plans, and Medicaid—followed by proactive phone follow-ups to expedite review timelines.

Status Tracking & Escalation Management

Real-time monitoring of authorization status with automated alerts for delays; immediate escalation to payer medical directors or peer-to-peer review when approvals are unjustly withheld.

Peer-to-Peer Coordination & Physician Advocacy

Facilitation of direct physician-to-physician conversations between your providers and payer reviewers to clinically justify medical necessity and resolve complex denials at the source.

Denial Appeals & Retroactive Authorization Recovery

Strategic appeals for denied authorizations with enhanced clinical evidence, regulatory citations, and urgent review requests—recovering revenue on services already rendered and preventing write-offs.

Why Choose Us

At Medi Flows, we treat every prior authorization as urgent—because delayed approvals mean delayed care and lost revenue.

Certified clinical staff and former payer reviewers who understand insurer decision logic and medical necessity standards

95%+ first-pass approval rate across 1,200+ U.S. payers through precise documentation and proactive follow-up

HIPAA-compliant technology with real-time authorization dashboards and EHR integration (Epic, Cerner, Athena)

Dedicated authorization specialists assigned by specialty (orthopedics, imaging, DME, injectables, etc.)

Guaranteed turnaround times: routine requests in 72 hours, urgent cases within 24 hours

FAQ’s about the Service

Q1. Which services typically require prior authorization?

Most imaging (MRI, CT), elective surgeries, specialty medications, DME (durable medical equipment), advanced therapies, and high-cost procedures require authorization. We maintain an updated database of payer-specific requirements by CPT code and state.

Q2. How quickly can you secure an urgent authorization?

For urgent/emergent cases (e.g., cancer treatment, acute cardiac procedures), we initiate same-day submission with expedited payer follow-up—often securing approvals within 4–24 hours depending on payer protocols.

Q3. Do you handle retroactive authorizations for already-rendered services?

Yes. We pursue retroactive approvals for services delivered without prior auth due to clinical urgency or administrative oversight—recovering 60–80% of otherwise denied claims through targeted appeals.

Q4. How do you access patient records and clinical notes for submissions?

We integrate securely with your EHR via encrypted remote access to pull necessary documentation. Alternatively, your staff can upload files through our HIPAA-compliant portal—no physical records required.

Q5. Can you manage authorizations across multiple states and payers?

Absolutely. Our team handles nationwide commercial payers, Medicare Advantage plans, and state Medicaid programs—with localized knowledge of regional policies, form variations, and contact protocols.

Q6. How do you keep up with constantly changing payer requirements?

We maintain direct relationships with payer provider services teams, subscribe to real-time policy update feeds, and conduct weekly internal training—ensuring our submissions always reflect current medical necessity criteria and form versions.

Dr. James Lin

Seattle, Washington

“After years of struggling with in-house billing, Medi Flows gave us clarity and control. Their reports are insightful, their staff is proactive, and our revenue cycle has never been smoother. They feel like an extension of our own team.”

Dr. Elena Rodriguez

Chicago, Illinois

“Medi Flows eliminated our billing backlog in weeks. Their attention to coding accuracy and insurer guidelines has boosted our collections by over 30%. Their support team is responsive, knowledgeable, and truly invested in our clinic’s financial health. Highly recommend.”

Marcus Whitfield

Phoenix, Arizona

“As a small practice, we couldn’t afford billing errors or delayed payments. Medi Flows streamlined everything—from eligibility checks to AR follow-ups. Now we get paid faster, deny fewer claims, and spend less time on admin. Worth every penny.”

Trusted Care. Proven Excellence

Get 25% flat discount for first appointment!

At Mediflows, we are dedicated to delivering exceptional billing support for over 20 years, we have been a offering comprehensive medical services in USA