Service
Eligibility & Prior Auth Support
The cheapest denial to fix is the one that never files.
Front-end work protects back-end collections
Eligibility failures, inactive coverage, and missing authorizations are among the most preventable denial classes. Medflux supports front-end revenue integrity: verifying coverage before or at service, capturing plan details that affect coding and billing, and coordinating prior authorization workflows for services that require them.
What is included
Eligibility verification workflows (batch and/or same-day, scoped to your schedule volume), benefits notes relevant to billing, referral and auth status tracking for in-scope services, and clear handoffs when the patient is out-of-network or auth is denied. We design the workflow around your scheduling reality — not a textbook that assumes unlimited staff time.
Prior authorization support
Auth requirements vary by payer and procedure. We help maintain checklists for high-volume services in your specialty, track pending auths, and surface gaps before the date of service when the schedule allows. Clinical documentation for medical necessity remains with the provider; we manage the administrative path and status.
What your practice sees
Fewer day-of coverage surprises, fewer auth denials after the fact, and cleaner claim data entering the billing queue. Front desk and clinical staff get a tighter pre-visit checklist instead of post-visit fire drills.
FAQ
Eligibility & Prior Auth Support questions
Our focus is eligibility and auth operations that protect claims. Patient scheduling and clinical triage stay with your practice unless a broader scope is explicitly agreed.
Yes. Some practices start with eligibility and auth support, then expand. Others include it inside full revenue cycle management.
Next step
Find out what your practice is leaving on the table.
A free review of your recent claims and denials — plain findings, no pressure theater.