Prior Authorizations for Services: Stay Ahead of the Changes

For healthcare providers, prior authorizations for services are more than just a formality — they are often the most frustrating and time-consuming part of delivering care. Every request requires time, documentation, and constant follow-up. When handled poorly, they lead to denials, delays, and patient dissatisfaction.

Recently, the highly publicized Johns Hopkins vs. UnitedHealthcare dispute exposed just how harmful excessive authorization requirements can be. Hopkins pointed to excessive prior authorizations, frequent denials, delayed payments, and heavy administrative burdens as obstacles that disrupt timely care. If one of the world’s top medical institutions struggles with prior authorizations, imagine the challenges private practices face every day.

At Taylor Prime Solutions, we make prior authorizations for services a seamless process. We handle the details, fight the denials, and ensure approvals happen quickly — so providers can focus on patients, not paperwork.

The Pain Points of Prior Authorizations for Services

• Time Drain: Providers and staff lose hours each week chasing approvals.

• Delays in Care: Patients wait days or weeks before receiving treatments.

• Denials: Missing or incorrect details cause frustrating rework.

• Staff Burnout: Administrative teams feel overwhelmed and frustrated.

• Revenue Risk: Delayed or denied authorizations mean delayed payments.

These issues don’t just affect revenue cycles — they directly impact patient outcomes, especially for those in critical treatment.

Our Process: How Taylor Prime Solutions Handles Prior Authorizations for Services

We’ve built a step-by-step system designed to simplify and streamline every request:

1. Verification & Intake – We verify coverage, benefits, and requirements before submission.

2. Documentation Collection – We gather clinical notes, treatment plans, CPT codes, and any payer-specific documentation needed.

3. Submission – Requests are submitted promptly via payer portals, fax, or phone, depending on insurer guidelines.

4. Tracking & Follow-Up – Every authorization is tracked in our system with reference numbers, timestamps, and expected turnaround times. We follow up consistently until approvals are secured.

5. Provider Updates – We communicate status updates so providers always know where a request stands.

6. Resolution & Appeals – If denied, we act immediately to resubmit or escalate the request with additional supporting documentation.

Handling Authorization Denials

When denials happen, we don’t stop at “no.” Our process includes:

• Root Cause Analysis: Identifying whether the issue was documentation, coding, or payer error.

• Corrective Resubmission: Reworking the request with stronger clinical notes and supporting evidence.

• Escalation: Contacting payer representatives or medical directors when necessary.

• Documentation Trail: Keeping detailed records so providers have a clear history for audits or compliance checks.

Our goal is simple: turn denials into approvals and prevent delays in care.

Prior Authorizations for Procedures

Many outpatient and inpatient procedures require prior authorization, from imaging (MRIs, CT scans) to surgeries. These approvals can take anywhere from 24 hours to two weeks, depending on the complexity.

Taylor Prime Solutions ensures that prior authorizations for procedures are submitted correctly the first time, with all clinical notes and test results included. By tracking expiration dates and authorization numbers, we prevent lapses that would otherwise delay care or jeopardize reimbursement.

Prior Authorizations for Medications

High-cost and specialty medications almost always require prior authorization. These include cancer therapies, injectables, mental health medications, and newer biologics.

Our team handles prior authorizations for medications by:

• Collecting prescriber notes and diagnosis details.

• Submitting directly through payer pharmacy benefit systems.

• Following up until approval is confirmed and documented.

This ensures patients receive their medications without dangerous delays, while practices avoid costly claim denials.

Prior Authorizations for Medical Equipment

Durable Medical Equipment (DME) — such as wheelchairs, CPAP machines, or prosthetics — often requires prior authorization. These requests are complex because they involve both clinical documentation and detailed equipment specifications.

Taylor Prime Solutions manages prior authorizations for medical equipment by:

• Gathering provider orders, medical necessity letters, and patient history.

• Submitting requests with accurate HCPCS codes.

• Tracking approvals and validity dates to ensure patients get their equipment without interruption.

How Long Do Prior Authorizations Take?

• Routine authorizations: 24–72 hours.

• Moderate complexity: 3–7 business days.

• High-cost services/medications: 7–14 business days (or more, depending on payer).

Because we track and follow up daily, our process reduces payer delays and shortens approval timelines.

Getting Down to the Nitty Gritty

Authorizations are rarely simple. They require persistence, knowledge of payer requirements, and the patience to handle constant back-and-forth. At Taylor Prime Solutions, we:

• Anticipate and prevent denials before they happen.

• Escalate with payers until approvals are secured.

• Communicate clearly so providers are never left wondering.

• Adapt to the trials and tribulations of each case, no matter how complex.

This nitty-gritty persistence is what separates us from in-house staff overwhelmed by competing responsibilities.

Why Providers Trust Taylor Prime Solutions

• Fewer Delays – Patients receive care faster.

• Fewer Denials – Requests are accurate and supported.

• Less Stress – Providers focus on care, not paperwork.

• Revenue Protection – Payments are secured with proper authorizations.

• Patient Trust – Patients see a seamless process, not insurance battles.

Take Back Control of Your Time

Prior authorizations shouldn’t hold your practice hostage. With Taylor Prime Solutions, you gain a partner who understands the process, fights through the red tape, and secures approvals so you can focus on patient care.

📞 Call us today at 844-829-5679 to see how we can simplify your prior authorizations for services, procedures, medications, and medical equipment. Or email us at taylor@taylorprimeemcee.com or send us a message via our contact form.