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.
“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
A dedicated specialist team watching every deadline, every payer, every case — so you don't have to.
Every payer, every state, every rule is tracked independently. Nothing falls through the cracks because a deadline was buried in an inbox.
Fewer denials and faster turnarounds mean fewer delayed procedures, fewer write-offs, and a healthier bottom line.
Your team stops spending their day on payer portals and hold queues. We handle the submissions, follow-ups, and appeals.
We know what documentation each payer needs up front, and act immediately when a denial or peer-to-peer review is requested.
Regular reporting on approval rates, turnaround times, and outstanding cases — so you always know where things stand.
Strict data handling and access controls protect patient information at every step of the process.
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.
Each engagement is scoped to your volume, specialties, and payer mix.
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.
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.
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.
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.
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.
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.
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.
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.