Insurance & Authorization
Every Payment Accounted For
We post insurance and patient payments accurately, reconcile accounts, and flag discrepancies before they affect your bottom line, keeping your financial records clear, organized, and accurate.
Insurance & Authorization
Approvals, Handled End To End.
Each step is staffed by dedicated specialists and tracked in real time — so coverage is confirmed and approvals are secured before the patient is ever seen.
Prior Authorizations
Every authorization request submitted, tracked, and followed up daily with payer-specific documentation — and renewed before it expires.
96% prior auths approved on first submission
Learn More →
Pre Certifications
Inpatient stays, procedures, and high-cost services pre-certified before they happen, with required clinical documentation packaged for the payer.
24 hrs average pre-certification turnaround
Learn More →
Eligibility Verification
Active coverage, plan status, copay, deductible, and limits confirmed across 1,200+ payers, 48 hours before the appointment.
99.2% eligibility accuracy before the visit
Learn More →
Benefits Investigation
Covered services, limitations, and patient responsibility confirmed up front, with accurate cost estimates before the procedure.
6% auth-related denials vs 18% industry average
Learn More →
Eligibility & Benefits VerificationEligibility & Benefits Verification
Verified Before The Visit. Not After The Denial.
Coverage that isn’t checked is coverage that fails at billing. CoreMedX verifies active eligibility for every scheduled patient across 1,200+ payers — plan status, group, copay, deductible, and coverage limits — 48 hours before the appointment, so front-desk surprises and avoidable denials disappear.
Our specialists flag inactive plans, coordination-of-benefits issues, and out-of-network risks before the patient walks in, giving your staff time to resolve coverage gaps instead of writing off the claim later.
Prior Authorization
Prior Auth Submitted, Tracked, And Approved.
Prior authorization is where revenue quietly stalls — auths expire, requests sit in payer queues, and procedures get rescheduled. CoreMedX submits, tracks, and follows up on every authorization request, with payer-specific documentation packaged correctly the first time.
Every pending auth is monitored daily until a determination comes back, and expiring approvals are renewed before they lapse — so the procedure happens on schedule and the claim pays the first time.
Benefits Investigation
Know Exactly What's Covered. Before You Bill.
A benefits investigation done right tells you what the payer will actually pay — not just what the card says. CoreMedX confirms covered services, limitations, prior-auth requirements, and patient responsibility for high-cost and specialty procedures before they’re performed.
Patients get accurate cost estimates up front, your practice avoids unexpected write-offs, and authorization-related denials drop well below the industry average.
Measured Results
Numbers That Define Our Standard
Eligibility Accuracy
First-pass acceptance rate across all payers, commercial, Medicare, and Medicaid.
Learn More →
Avg Auth Turnaround
Denied claims overturned on appeal, versus a 42% average for in-house billing teams.
Learn More →
Auth Approval Rate
Average days from claim submission to payment posting, versus a 38-day industry average.
Learn More →
Auth-Related Denials
Average improvement in net collections within 6 months for practices onboarded to CoreMedX.
Learn More →
Stop Losing Claims Before They're Filed.
Book a free 20-minute review with a CoreMedX specialist. We’ll show you exactly where coverage and authorization gaps are costing you, no commitment, no obligation.