@keyframes pulse { 0%, 100% { opacity: 1; } 50% { opacity: .5; } } Accelerating Approvals, Eliminating Delays
HBS Prior
Authorization
Protocols.
Standard Operations
Our General Authorization Protocol
1
Proactive Verification
We identify authorization requirements instantly during the eligibility verification phase, long before the patient’s scheduled appointment.
2
Clinical Documentation Assembly
Our AAPC/AHIMA certified experts meticulously gather and align your progress notes, lab results, and imaging with payer-specific medical necessity guidelines.
3
Real-Time Submission
We submit requests directly through payer portals and clearinghouses, maintaining aggressive, continuous follow-up until a determination is made.
4
Peer-to-Peer & Appeal Support
If a denial occurs, we immediately prep your providers for peer-to-peer reviews with organized clinical highlights and manage the entire appeals process.
Specialty Focus
The WISER
Program:
Advanced Prior
Auth for Biologics
The approval process for high-cost biologic therapies requires a significantly higher level of scrutiny. To meet this challenge, HBS employs our specialized WISER program.
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Navigating Step-Therapy
We thoroughly document the patient’s clinical history to successfully navigate payer "fail-first" policies and complex step-therapy requirements.
Granular Clinical Matching
Biologics approvals hinge on exact details. We ensure every precise metric—from targeted joint counts to specific biomarker thresholds—is perfectly highlighted.
Expedited Pathways
We leverage established payer relationships and expedite urgent biologic requests to ensure patients receive their critical specialty medications without interruption.
Continuous Re-Authorization
Biologics often require ongoing approvals. Our WISER protocol tracks expiration dates and proactively initiates re-authorizations before current approvals lapse.