Keep Prior Authorization Work Moving with Clear Ownership
ATS Healthcare manages defined administrative steps across the prior authorization workflow—from requirement checks and record review to request preparation, submission, payer follow-up and status communication. Your team gains a visible process while clinical decisions remain with the provider and authorization decisions remain with the payer.
- Practice-Specific Support
- Experienced Healthcare Team
- Experienced Healthcare Team
- Existing-System Compatible
Prior Authorization Support from Requirement Check to Payer Decision
ATS Healthcare provides prior authorization support for independent practices, medical groups, FQHCs and RHCs. Within the agreed scope, ATS can verify payer requirements, coordinate required documentation, prepare and submit requests, monitor status, follow up on additional-information requests and communicate the payer’s response to the practice.
A More Consistent Way to Manage Every Request
Requirement Review
Confirm coverage details and the payer-specific authorization, referral, notification or documentation requirements that apply.
Record & Information Coordination
Identify the clinical and administrative information required, then coordinate missing items with the responsible practice team.
Request Preparation
Organize the request so the payer receives the required patient, provider, service and supporting information.
Submission
Send the request through the approved payer channel and record the submission date, reference number and supporting documents.
Payer Follow-Up
Monitor pending requests, respond to administrative questions and follow the payer’s stated process for additional information.
Decision & Next-Step Coordination
Record approval, denial, partial approval or other response and route the appropriate next action to the practice.
Status Communication
Keep the practice informed through agreed statuses, updates and escalation when a request may affect scheduling or care coordination.
Workflow Reporting
Provide visibility into request volume, status, aging, payer responses and unresolved actions within the available system and agreed scope.
Clear Responsibilities from Clinical Order to Payer Response
The Practice & Clinician
Determine the treatment plan, document medical rationale, provide complete clinical information and make clinical decisions.
ATS Healthcare
Manage the agreed administrative workflow, submission, tracking, follow-up, documentation and status communication.
The Payer
Sets coverage criteria, requests supporting information, controls review timing and makes the authorization decision.
Important Limitation
Authorization is not a guarantee of claim payment. Eligibility, coding, coverage, medical necessity and other claim requirements still apply.
Support Adapted to Your Practice Environment
Independent & Small Practices
Add authorization capacity without relying on one internal team member to remember every payer-specific next step.
Medical Groups & Multi-Site Practices
Create more consistent ownership, status communication and escalation across providers, specialties or locations.
FQHCs & RHCs
Align authorization support with the organization’s payer mix, care model, internal resources and operational priorities.
Primary Care & Specialty Practices
Adapt the workflow to the services, treatments, medications or procedures handled by the practice and its payers.
A Defined Workflow with Visible Next Actions
Assess
Review request types, payer mix, systems, volumes, current ownership and the source of delays or rework.
01
Define
Agree on scope, clinical and administrative responsibilities, submission channels, statuses, escalation paths and communication cadence.
02
Operate
Prepare and submit complete requests, track payer responses and keep each request assigned to a visible next action.
03
Review
Use status and aging information to discuss recurring documentation gaps, payer issues and workflow priorities.
04
Know Where Each Request Stands
ATS uses agreed status communication and reporting so the practice can distinguish requests that need clinical information, are ready to submit, are pending payer review, require follow-up, have received a decision or need a documented next step. Available reporting depends on the practice’s systems, payer channels and agreed service scope.
Experienced Support That Fits the Way Your Practice Works
The working model reflects your specialties, payer mix, systems, request volume and internal responsibilities. A dedicated point of contact supports coordination and escalation, while an experienced healthcare team works within the agreed process. ATS reviews system and access requirements before implementation rather than assuming compatibility.
Build a Stronger Internal Prior Authorization Workflow
Read the ATS Healthcare guide for a practical seven-step workflow covering ownership, requirement checks, documentation, submission, tracking, payer responses and process review.
Prior Authorization Service FAQs
What is prior authorization?
Prior authorization is a payer process that may require a provider to obtain advance approval before a service, procedure, treatment or medication can qualify for coverage under the patient’s plan.
Which parts of prior authorization can ATS manage?
Depending on the agreed scope, ATS can support requirement checks, record and information coordination, request preparation, submission, payer follow-up, response documentation and status communication.
Does ATS make the decision or guarantee payment?
No. The payer applies its coverage criteria and makes the authorization decision. Authorization does not guarantee claim payment because eligibility, coding, benefit limits, medical necessity and other payer requirements may still apply. The clinician remains responsible for the treatment plan and clinical rationale; ATS manages the agreed administrative workflow.
Discuss the Requests Creating the Most Pressure
