Trusted by Healthcare Teams • 40+ Payers • HIPAA Secure
Prior & Retro Authorization
Outsourcing Services

Stop Losing Revenue to Authorization Delays

Your team belongs at the bedside, not on hold with payers. Svizzera manages your complete prior and retro authorization lifecycle: submission, payer follow-up, denial appeals, and retrospective authorization for emergency and unplanned care.

All major commercial & government payers

First-level appeals included, not an add-on

HIPAA-focused · BAA provided at onboarding

No EHR changes · 5–10 business days launch

OUR AUTHORIZATION SERVICES

Everything We Handle For You

Three integrated services managed by the same dedicated team, inside your existing EHR, with no workflow disruption.

Pre-Service Approval

Prior Authorization

Advance payer approval managed end-to-end so your clinical team never touches a portal, fax, or payer hold queue.

Eligibility & benefit verification
Payer portal, fax & phone submissions
Real-time status tracking
Letters of medical necessity support
Re-authorization monitoring
Approval documentation
Post-Service Recovery

Retro Authorization

Post-service authorization for emergency care, urgent procedures, or oversight cases with deadline-driven rapid response.

Rapid case identification
Clinical documentation assembly
Retro authorization submission
Payer review tracking
Emergency care support
Outcome documentation
Appeals & Resolution

Denial Management

When payers deny, we fight with clinical documentation, formal appeals and peer-to-peer coordination.

Denial reason analysis
First-level appeal submission
Clinical documentation support
Peer-to-peer review coordination
Appeal deadline management
Denial reporting
HOW IT WORKS

The Authorization Lifecycle We Own From End to End

From eligibility check through payer follow-up to billing handoff, our team guarantees proactive tracking every step of the way.

01Phase 01
Eligibility & Requirements Check

Eligibility & Requirements Check

We verify active coverage and confirm whether authorization is required before submission.

02Phase 02
Payer Submission

Payer Submission

We prepare and submit all required documents through payer portals, fax, or approved channels.

03Phase 03
Status Tracking & Follow-Up

Status Tracking & Follow-Up

We proactively follow up with payers until an approval, denial, or additional request is received.

04Phase 04
Denial Appeals

Denial Appeals

When payers deny requests, we prepare and submit first-level appeals with supporting documentation.

05Phase 05
Billing Handoff

Billing Handoff

Approved authorizations are documented and handed back to your billing team.

INDUSTRY INSIGHT
80%

of appealed denials can be overturned with proper documentation and timely submission.

Source: Becker's ASC Review industry benchmark.

WHY SVIZZERA

Why Healthcare Teams Choose Svizzera

Built for healthcare organizations that need faster authorizations without increasing administrative burden.

5-10 Days

Operational Onboarding

Most teams are operational within 5 to 10 business days.

40+

Payer Protocols Supported

Commercial, Medicare Advantage and regional payer workflows.

HIPAA

BAA Provided

Security and compliance documentation provided during onboarding.

No EHR Changes

Works Inside Existing Systems

No major implementation or software migration required.

MAJOR PAYERS WE SUBMIT TO

UnitedHealthcare
Aetna
Cigna
Humana
BCBS Plans
Medicare Advantage
Medicaid MCO
Molina
Centene / WellCare
Tricare
Regional Carriers
UnitedHealthcare
Aetna
Cigna
Humana
BCBS Plans
Medicare Advantage
Medicaid MCO
Molina
Centene / WellCare
Tricare
Regional Carriers
UnitedHealthcare
Aetna
Cigna
Humana
BCBS Plans
Medicare Advantage
Medicaid MCO
Molina
Centene / WellCare
Tricare
Regional Carriers
UnitedHealthcare
Aetna
Cigna
Humana
BCBS Plans
Medicare Advantage
Medicaid MCO
Molina
Centene / WellCare
Tricare
Regional Carriers
FAQ

Frequently Asked Questions

Answers to the most common questions healthcare organizations ask before partnering with Svizzera.