01
Request submission.
Medical-necessity documentation compiled. Request submitted in the payer-preferred format (portal, fax, EDI). Tracked to confirmation number.
Prior authorization
Prior Authorization Services for Consistent Scheduling.
A dedicated prior auth team runs your payer specific workflows from submission to escalation. We handle the documentation and portal tracking to reduce bumped procedures and ensure your cases start as planned.
Recognized by Clutch
Top 2026 Awards for Virtual Assistants, Medical Billing, and US BPO
Verified client reviews
What clients say on Clutch.
Unfiltered, third-party-verified reviews pulled live from our Clutch profile.
Why HelpSquad for prior authorization
Prior auth eats practices alive. We run the playbook.
Four reasons a dedicated prior-auth team pays for itself in the first quarter.
01
Payer-portal fluent.
Anthem, Aetna, UHC, Cigna, BCBS, Medicare Advantage plans - each with their own portal, submission format, and escalation path. The team works them daily.
02
Clinical docs chased.
Missing chart notes, imaging reports, prior lab results - chased from clinicians or outside records before the request gets bounced.
03
Status tracked, not just submitted.
Prior auths are watched from submission to approval. Status checked against SLAs, payers chased when they miss their own deadlines.
04
Escalation when payers stall.
Peer-to-peer reviews scheduled. Appeals filed on denials. Repeat offenders reported back to your ops team so patterns surface.
How we show up
Six lanes of prior authorization.
Start with one area of support and add more as you see the results.
02
Clinical documentation chasing.
Missing notes, imaging, lab results, or specialist letters requested from clinicians or outside offices. Submitted to payers before deadlines.
03
Status tracking across portals.
Daily portal checks. Payers chased if they miss SLAs. Status updates pushed to your EHR or shared dashboard for visibility.
04
Peer-to-peer review coordination.
When payers want a peer-to-peer, we schedule it with the clinician, prep the case summary, and confirm approval post-call.
05
Appeals on denials.
First-level appeals filed with payer-specific templates and supporting documentation. 87% first-appeal success rate across our healthcare book.
06
Specialty-specific workflows.
Surgical, cardiology, radiology, infusion, genetic testing, orthopedic, behavioral health - each with documented prior-auth playbooks.
Healthcare
Hi Ena, I just wanted to take a second to highlight that you have been doing a fantastic job with the handling of patient billing calls! I've noticed a stark improvement in our collection efforts and the feedback from patients has been positive overall. Keep up the great work!
Billing Manager
Multi-location practice
Tools we work with
Trained on your payer stack.
We meet you in the tools you already use. Training built into onboarding.
AvailityWaystarChange HealthcareCoverMyMedsSurescriptsUHC LinkAetna PortalAnthem PortalBCBS PortalsMedicare Advantage PortalsEpicAthenaCerner+ custom toolsAvailityWaystarChange HealthcareCoverMyMedsSurescriptsUHC LinkAetna PortalAnthem PortalBCBS PortalsMedicare Advantage PortalsEpicAthenaCerner+ custom tools
Healthcare operations in production
A six-figure A/R recovery in 60 days.
A New Jersey dental practice running three dedicated VAs across appointment calls, billing follow-up, and EHR data entry - aged A/R cleared in 60 days, around-the-clock patient coverage without adding in-house staff.
Transparent pricing
Simple rates. Nothing to hide.
We publish our rates because we're proud of them. No hidden fees, no bait-and-switch. Engagements typically start at 20 hours per week, and every rate includes our HIPAA-compliant technology and the backing of a US-based company.
$8-$13/hour for staffing.
Managed teams custom-priced.
Managed teams custom-priced.
$0
Upfront cost
$0
Implementation fees
$0
Replacement costs
Back Office (Digital)
$ 8-10
per hour | digital-only · email + chat
- Billing, claims, AR, data entry
- Admin, research, scribe
- Experienced on your EHR
- HIPAA BAA + virtual desktop
- Dedicated account manager
Most popular
Patient-Facing (Voice)
$ 10-13
per hour · phone + video
- Front desk, scheduling, intake
- Experienced on your EHR
- Screened for clear US-patient communication
- HIPAA BAA + virtual desktop
- Dedicated account manager
Managed Team
Custom
3+ VAs · team lead + QA + trainer
- Fully managed (3+ VAs)
- Specialty: clinical or RN-equivalent
- Workforce management, QA, training & coaching
- Monthly analytics reporting
- Dedicated account manager
Ready to get started?
No more bumped cases. No more phone tag with payers.
Prior auth is the highest-ROI back-office outsource for surgical, cardiology, orthopedic, and specialty practices. Talk with us and we'll scope the prior-auth volume for your specialty.
Frequently asked
Answers before you ask.
Which specialties need this most?
Surgical practices, ortho, cardiology, radiology, infusion, genetic testing, DME, and specialty pharmacy see the highest prior-auth volume and the biggest benefit from outsourcing.
What is your first-appeal success rate?
87% first-appeal success on denied claims across our healthcare book. Specific workflows per payer, per denial reason.
Do you schedule peer-to-peer reviews?
Yes. Coordinator handles scheduling, prep, and post-call confirmation. Clinician just shows up for the 10-minute call.
Which payers do you work with?
Every major commercial (Anthem, Aetna, UHC, Cigna, BCBS), Medicare Advantage plans, Medicaid, TRICARE, VA, and regional payers.
How much does prior-auth coverage cost?
$8-10/hour for back-office prior-auth work. See full pricing →
Can prior-auth be caught during insurance verification?
Yes - that's how we prefer to work it. Insurance verification flags prior-auth requirements upstream so they're on the queue before the appointment is booked. See our verification service →
How quickly will we see approval-time improvement?
Within 30-60 days. Consistent daily portal checks and SLA enforcement typically cut approval time by 30-50% on specialties that were running a backlog.
Healthcare
Prior Authorization Outsourcing for Medical Practices: A Practical Workflow Checklist
Practices lose 13 hours a week chasing insurance approvals. This healthcare guide lays out a prior auth outsourcing workflow that frees front-desk and billing staff.
HelpSquad
5 Ways to Deal with an Overload of Insurance Claims
Claims volume spiking past what your team can handle? Five practical ways insurance agencies are coping, from rehiring retirees to shifting workloads.
Healthcare
Claims Denial Management in 2025: Best Practices, Tools, and Trends
Hospitals spent nearly $20 billion fighting denied claims in 2022. This guide covers prevention-first claims processing, predictive analytics, and 2025 trends.
Ready to scale prior authorization?
Let's build the squad your practice needs.
A 30-minute call. We'll scope the work, pre-qualify candidates, and give you a realistic go-live timeline.
877-775-3667 · info@helpsquad.com · Doylestown, PA