What are prior authorization services?

Prior authorization services manage the process of confirming payer requirements, collecting clinical documentation, submitting authorization requests and tracking each request until a decision is received.

How does MedSole RCM track prior authorization requests?

MedSole RCM tracks the status of each prior authorization request and provides healthcare practices with visibility into pending documentation, payer responses, approvals and requests requiring additional action.

Can prior authorization services help reduce claim denials?

A structured prior authorization process can help reduce authorization-related denials by verifying payer requirements, submitting the required documentation and following up before scheduled services are delivered.

Which payers does MedSole RCM work with?

MedSole RCM supports prior authorization workflows across more than 900 commercial, Medicare, Medicaid and managed-care payers in the United States.

Does MedSole RCM offer a prior authorization process review?

Yes. Healthcare providers can request a free process review to identify documentation gaps, delayed follow-ups and other issues affecting authorization turnaround times.

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PRIOR AUTHORIZATION SERVICES

Prior Authorization Services Built Around the Documentation Payers Require

Name: MedSole RCM
Rating: 4.9

Every authorization request gets the clinical documentation it needs before it reaches a payer, tracked from submission to decision, so a delay doesn't turn into a denied procedure.

MedSole RCM built this for practices tired of watching authorizations stall in a payer queue. You get a specific status on every request, submitted, pending, or approved, not silence while a scheduled procedure waits.

Call Us +1 (602) 563 5281

99%

Clean Claim Rate

12–24

Hour Entry Turnaround

900+

Payers in Network

States Served

Clinical Documentation Assembly

We pull the clinical notes, test results, and medical necessity justification each payer asks for, and check it against that payer's criteria before the request goes out.

Payer-Specific Requirement Check

Not every payer requires authorization for the same procedures. We confirm what that specific payer needs before submission, not after a claim comes back denied for missing authorization.

Submission and Status Tracking

Every request is submitted and tracked from the moment it's sent, so you know if it's pending, approved, or flagged for more information, instead of guessing.

Turnaround Follow-Up

Requests sitting past a payer's normal response time get followed up on, instead of waiting for the payer to reach out first.

Appeals

A denied request doesn't sit unreviewed. We check the reason, correct what's missing, and resubmit or appeal, so one denial doesn't turn into a canceled procedure.

Reporting

You see turnaround time, approval rate, and denial reasons by payer, so you know where requests are getting stuck.

WHY CHOOSE MEDSOLE

Why Practices Choose MedSole for Prior Authorization Services

MedSole handles the parts of prior authorization that determine whether a request gets approved, not the parts that are easy to automate.

Documentation Payers Require

We pull the clinical notes, test results, and medical necessity justification each payer requires, checked against their specific criteria first.

Payer-Specific Requirements

Not every payer requires authorization for the same procedure. We confirm what that specific payer needs before the request goes out.

A Status on Every Request

Every request shows a specific status: pending, approved, or flagged for more information, tracked from submission through decision.

Appeals Without Restarting

A denied request gets reviewed and corrected, then resubmitted or appealed, so your staff is not restarting the whole authorization from scratch.

HOW PRACTICES ENGAGE MEDSOLE

Two Ways to Handle Prior Authorization

Standalone Prior Authorization

Priced by request volume

Covers documentation assembly and submission
Payer-specific requirements confirmed before submission
Status tracked from submission through decision
No setup fee
Cancel anytime

Get Your Custom Quote

Best Value

Included Free Inside Full-Service RCM

FREE / Included in your 2.99% rate

No separate authorization charge inside full RCM
Included at the 2.99% collections rate
Covers claims submission, coding, and denial management too
All 8 RCM stages covered, registration through reporting
Every request tracked in your dashboard
One team handles your whole revenue cycle

See What's Included in Full RCM

Transparent pricing. No hidden fees. No surprises.

WHERE ARE YOU RIGHT NOW

Which of These Describes Your Prior Authorization Process?

Most prior authorization problems stay invisible until a scheduled procedure gets delayed or denied. Check what's happening in your practice below.

Select What Applies to Your Practice

Still handling prior authorization in-house Already outsourced, but turnaround is too slow New to outsourcing, not sure where to start Getting denials for missing or incomplete documentation Losing track of requests once they're submitted

Get a Clear Answer on Where Your Requests Stand

A free review looks at how your prior authorization requests are handled right now: how they're documented, how long they sit before a decision, and where they get stuck. You'll see the gaps before you change anything.

WHAT PRACTICES ASK

Questions Practices Ask About Prior Authorization Services

Everything you need to know about pricing, timelines, and what happens once you send us your aging report.

Still have questions?

Can't find the answer you're looking for? Our billing specialists can walk you through how benefit verification fits your practice.

Q1 What services typically require prior authorization?

It varies by payer and plan, but imaging, planned surgeries, specialty medications, and certain outpatient procedures are common triggers. We confirm what a specific service requires before it gets scheduled.

Q2 How long does prior authorization take?

laim.It depends on the payer and the procedure. We track each request against that payer's normal response time, so you know when a delay is a real problem, not a normal wait.

Q3 What happens if a request gets denied?

We check the reason, correct what's missing, and resubmit or appeal, so the denial doesn't turn into a canceled procedure.

Q4 How much does standalone prior authorization cost if I don't need full RCM?

Standalone prior authorization is scoped and priced based on request volume and specialty. For practices running full-service RCM with MedSole, it's included at no separate charge inside the 2.99% of collections rate.

Q5 Can this work inside my existing EHR?

Yes. We work inside the EHR or practice management system your practice already uses, with no data migration required.

Q6 Does this account for CMS electronic prior authorization requirements?

Requests are handled in the format each payer requires, including electronic submission where a payer mandates it.