A Healthcare Inspired Service

Stop losing revenue to missed authorizations.

Our prior authorization specialists manage your payer requests from intake to decision, so your staff stops chasing deadlines, denials go down, and patients get care on schedule.

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
Benefits

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.

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.

How It Works

A simple handoff. We do the work, you see the results.

01
We Learn Your Practice

Your specialties, payers, and workflows — so our team fits right into how you already operate.

02
You Send the Request

A quick referral through the client portal, and our specialists take it from there.

03
We Manage the Payer

Submissions, follow-ups, documentation requests, and appeals — handled by people who know each payer.

04
You Get the Answer

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.

What's Included

End-to-end authorization support.

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
  • Monthly reporting on approvals, denials, and turnaround
HCI Managed Service Pricing

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.

5 physicians
140+

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.

$10/auth

Pharmacy/PBM and 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 pharmacy/DME authorizations — priced to beat typical in-house processing cost ($11–$90/transaction per published industry research), not as a percentage of a payment.

$28/auth

Diagnostic imaging authorizations — single-step payer review, lower documentation burden.

Typically ~13–19% of a $150–$220 imaging reimbursement.

$60/auth

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.

$125/auth

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

$0/mo

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.

Who We Serve

Built for the teams we consult with

Healthcare Inspired's independent consultants bring coding, billing, auditing, credentialing, compliance, and education expertise to:

Medical Practices

Physician groups and specialty clinics with high volumes of imaging, procedures, and injections.

Hospitals & Health Systems

Outpatient departments and service lines that depend on timely payer decisions.

Ambulatory Surgery Centers

Surgical schedules that can’t wait on late or missing authorizations.

Patient Access Teams

Front desk and scheduling staff who need authorizations handled before the visit.

OrthopedicsSpinePain ManagementImagingGeneral SurgeryENTUrologyOphthalmologyGastroenterologyCardiologyBehavioral Health

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.