Prior Authorization Desk
Custom monthly quote
Authorization backlog and expired approvals.
Prior Authorization
Less Prior Authorization Backlog. More Visibility.
Authorizations stall when requests sit unsubmitted or unchecked in a portal.
The problem
Procedures get rescheduled because an authorization was never submitted, or was approved and expired before the visit.
How we help
Requirement checks, submission, tracking, and outcome routing.
Best for: Imaging and procedure-heavy specialties, Orthopedics and pain management, Behavioral health, Dental offices with frequent major-service pre-determinations.
Scope
What is included
Clinical documentation intake
Documentation received from your authorized clinical team through approved channels.
Requirements check
Confirmation of whether the payer and plan require authorization for the service and location.
Submission and tracking
Request preparation and submission by portal, fax, or phone, logged with dates and reference numbers.
Payer follow-up
Scheduled status checks with outcomes recorded on the authorization log.
Outcome routing
Approvals, denials, and requests for more information routed to named staff.
Appeal coordination
Appeal and peer-to-peer logistics coordinated, with clinical arguments provided by your clinicians.
Expiration tracking
Alerts when approved authorizations near expiry or visit limits.
Not included
- Medical necessity determinations
- Writing clinical justification
- Guaranteed approvals or approval timelines
How it works
Step by step
- 01
Payer rules map
We document which services require authorization by payer.
- 02
Intake channel
Your team flags orders and supplies documentation.
- 03
Submit
Requests prepared and filed with a log entry.
- 04
Track and follow up
Each request has a next-check date.
- 05
Route outcomes
Decisions go to the right person promptly.
- 06
Monitor expirations
Upcoming expirations are flagged before visits.
- 01Clinical documentation intake (client team)
- 02Requirements check
- 03Submit & track
- 04Payer follow-up
- 05Outcome routing
- 06Appeal coordination
- 07Expiration tracking
Medical necessity decisions remain with licensed clinicians. No approval is guaranteed.
What you keep control over
- All clinical content and medical necessity decisions
- Which services are submitted
- Appeal decisions
- System access
Compliance note
Where our work requires access to protected health information, it begins only after a signed services agreement and, as applicable, a business associate agreement (BAA). We use the minimum necessary access in client-owned systems. Our group security practices are ISO/IEC 27001-focused; that framework supports, but does not by itself establish, HIPAA compliance, which remains a shared responsibility defined by your agreements and safeguards. Medical necessity decisions remain with licensed clinicians and payers.
More detail
Open any topic below.
Background and common problems
Authorizations stall when requests sit unsubmitted or unchecked in a portal. We run the administrative workflow end to end while medical necessity decisions stay with your licensed clinicians.
Prior authorization is a high-volume administrative process with real consequences for patients and revenue. The work is repetitive but unforgiving: requirements differ by payer and plan, clinical documentation must be complete, status must be checked, and approvals expire.
Zincat operates the administrative side of that process. Your authorized clinical team supplies documentation; we check requirements, prepare and submit requests, track them, follow up with payers, and route outcomes back to the right person. We coordinate appeals and track expiration dates. We do not make medical necessity determinations, and no vendor can guarantee approval.
- Requests waiting days to be submitted
- Pended requests with no follow-up
- Missed requests for additional clinical information
- Expired approvals discovered on the day of service
- No single log of open authorizations
Sample reporting
An example of the kind of summary you would receive. Figures are demo data, not results.
DEMO DATA · NOT A CLIENT REPORT
- Open requests
- 38
- Decided this week
- 27
- Awaiting clinical info
- 5
- Expiring in 14 days
- 8
- Median days to decision
- 4.2
Is outside support the right choice?
| Option | Works well when | Watch for |
|---|---|---|
| Keep fully in-house | Volume is steady, staff are trained, and reports are reviewed regularly. | Single points of failure when someone leaves or is out. |
| Targeted outside support | One queue (verification, A/R, credentialing) keeps falling behind. | Clear hand-offs so nothing falls between teams. |
| Broader outsourced RCM | Multiple stages are stretched and leadership wants one accountable partner. | Requires assessment, BAA, and well-defined metrics first. |
What to have ready
- Recent A/R aging and denial reports (no patient details in email)
- List of PMS/EHR, clearinghouse, and payer portals used
- Approximate monthly claim or appointment volume
- Who on your team will approve access and escalations
Related packages
Ways to engage
Prices are illustrative starting points pending management approval and are confirmed only in a written proposal.
FAQ
Prior Authorization questions
Often paired with
Related reading
Do you decide whether a procedure is medically necessary?
No. Medical necessity decisions remain with your licensed clinicians and the payer. We handle the administrative workflow of preparing, submitting, and tracking requests.
Can you guarantee approvals?
No. Approvals depend on payer policy and clinical documentation. Our role is to make sure requests are complete, submitted, tracked, and never forgotten.
How do we send clinical documentation?
Through secure channels agreed during onboarding, typically within your EHR or a designated secure system. Never through this website or unsecured email.
Do you handle peer-to-peer reviews?
We can coordinate scheduling and logistics. The clinical discussion is conducted by your provider.
What if the payer requests more information?
The request is routed to the named clinical contact immediately with the due date, and the log is updated so it is not missed.
Can you track authorization expirations?
Yes. Approved authorizations are logged with expiry dates and visit counts so your scheduling team is alerted in advance.
Next step
Talk through your prior authorization workflow.
Tell us how things run today. We will point out where we see friction and be honest about whether we can help.