Eligibility & Authorization Services | Forte Revenue
REVENUE CYCLE

Eligibility & Authorization Services

Real-time benefits verification and prior authorization management to prevent denials and accelerate payments

98%
Authorization success
24h
Average turnaround
500+
Payers covered

Our Eligibility & Authorization Services

Comprehensive coverage verification and approval management

Eligibility Verification

Real-time verification of patient coverage, benefits, and financial responsibility

Real-time checks Benefits breakdown Coverage details Patient liability Deductibles

Benefits Discovery

Detailed benefits analysis including copays, coinsurance, and coverage limitations

Copay amounts Coinsurance Out-of-pocket max Coverage limits Network status

Prior Authorization

Complete management of auth requests from submission to approval

Clinical review Payer criteria Peer-to-peer Appeals Reauthorizations

Notification Management

Inpatient and outpatient notifications to meet payer requirements

Inpatient notices Outpatient notifications Timely filing Payer rules

Referral Management

Tracking and verification of referrals between providers

Referral tracking Specialist coordination PCP requirements Network rules

Authorization Follow-up

Proactive follow-up on pending and expiring authorizations

Status tracking Expiration alerts Renewals Payer follow-up

Our Authorization Process

Streamlined workflow from request to approval

01

Request Received

We gather patient, provider, and procedure details

02

Benefits Verified

Real-time eligibility and coverage confirmation

03

Auth Submitted

Complete submission with all required clinicals

04

Follow-up & Approval

Persistent follow-up until authorization secured

Why Providers Choose Us

Reduce denials and accelerate payments

Reduce Denials

Catch eligibility issues before services are rendered

Faster Payments

Clean claims with proper authorization attached

Patient Satisfaction

Accurate estimates of patient financial responsibility

Compliance

Meet all payer requirements for timely filing

Reduced Write-offs

Prevent services rendered without proper auth

Staff Efficiency

Free your team from administrative burden

Typical Authorization Timelines

Radiology MRI, CT, PET scans 24-48 hours
Surgery Inpatient and outpatient procedures 3-5 days
Specialty Meds Specialty pharmacy medications 2-7 days
Behavioral Health Inpatient and intensive outpatient 24-72 hours
DME Durable medical equipment 2-5 days

Payers We Cover

Eligibility and authorization with all major plans

Medicare
Medicaid
Aetna
Cigna
UnitedHealthcare
Blue Cross
Humana
Kaiser
Centene
Molina
Anthem
WellCare
Health Net
Tricare
VA
BCBS
Oscar
Ambetter
Coventry
MultiPlan

Stop Authorization Delays

Let our team handle eligibility and prior authorizations so you can focus on patient care

Schedule Free Consultation

No long-term contracts • Month-to-month available

98% authorization rate 24-hour turnaround 500+ payers All specialties