Clutch 2025 Global Award Winner · Top 15 Worldwide in Customer Support Outsourcing · Managed Virtual Medical Assistants
Prior authorization

Prior authorization so cases never get bumped.

Dedicated prior-auth team running payer-specific workflows - submitting requests, chasing clinical documentation, tracking status across portals, and escalating when payers stall. Fewer bumped procedures, cleaner case starts.

From $8/hr·HIPAA + BAA·Payer-portal trained·Live in ~2 weeks
Recognized by Clutch
Top 2025 awards for Customer Support, Virtual Assistants, and E-commerce Call Centers
Top Clutch Customer Support Outsourcing Company US 2025Top Clutch Virtual Assistant Company US 2025Top Clutch Call Centers E-commerce 2025
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 lane; we expand as the engagement earns its keep.

01

Request submission.

Medical-necessity documentation compiled. Request submitted in the payer-preferred format (portal, fax, EDI). Tracked to confirmation number.

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, mental health - each with documented prior-auth playbooks.

Tools we work in

Trained on your payer stack.

We meet you in the tools you already use. Custom tool training built into onboarding.

AvailityWaystarChange HealthcareCoverMyMedsSurescriptsUHC LinkAetna PortalAnthem PortalBCBS PortalsMedicare Advantage PortalsEpicAthenaCerner+ custom tools
Transparent pricing

Simple rates. Nothing to hide.

We publish our rates because we're proud of them. No hidden fees. No surprise minimums. No bait-and-switch. You only pay for hours worked.

$8-$12/hour.
That's it. That's the whole range.
$0
Upfront cost
$0
Implementation fees
$0
Replacement costs
Back Office
$ 8-10
per hour · billing, claims, data entry
  • Insurance verification
  • Medical billing & AR
  • Claims processing & appeals
  • Pre-qualified candidates
  • HIPAA BAA included
Get started
Managed Team
Custom
team lead + multiple VAs + QA
  • Full managed service
  • Workforce management & QA
  • Monthly analytics reporting
  • Ideal for 3+ seats or 24/7
  • US-based operations lead
Request a quote
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. Book a consultation and we'll scope the prior-auth volume for your specialty.

In their words

What clients say about working with us.

H.E.R. Accessories
Having a real person is what we were looking for. HelpSquad has provided a good business model and support over the past 3 years.
Mason Bottle
The price is excellent for the quality of the service. Agents and coaches learn quickly and give customers an authentic experience with our brand.
VELLO
Within the first 3 months we expanded our hours of active guest communication by about 25% and delivered approximately 33% labor cost savings.
MultiSoft Corporation
They handle all of our live support 24x7x365. Awesome customer service.
Kofile Technologies
Professionals who have always proven themselves trustworthy and beneficial to our support staff.
N.J. Hair Center
It's like having someone there 24/7 to answer questions.
Simple Agency
Agents learn how to answer the top questions prospects ask, custom to YOUR business.
Spark Orthodontics
Good communication between company and customer.
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.
Verified client reviews

What clients say on Clutch.

Unfiltered, third-party-verified reviews pulled live from our Clutch profile.

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 · Hatboro, PA