🟢 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 · Operational in 5–10 business days
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.
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
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
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
MAJOR PAYERS WE SUBMIT TO
UnitedHealthcare
Aetna
Cigna
Humana
BCBS Plans
Medicare Advantage
Medicaid MCO
Molina
Centene / WellCare
Tricare
Regional Carriers
HOW IT WORKS
The Authorization Lifecycle
We Own From End to End
1
Eligibility & Requirements Check
We verify active coverage and confirm whether authorization is required before submission.
2
Payer Submission
We prepare and submit all required documents through payer portals, fax, or approved channels.
3
Status Tracking & Follow-Up
We proactively follow up with payers until an approval, denial, or additional request is received.
4
Denial Appeals
When payers deny requests, we prepare and submit first-level appeals with supporting documentation.
5
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.
FAQ
Frequently Asked Questions
Answers to the most common questions healthcare organizations ask before partnering with Svizzera.
How long does onboarding take?
Most healthcare teams are operational within 5 to 10 business days depending on payer complexity and documentation requirements.
Do we need to change our EHR system?
No. Svizzera works inside your existing workflows without requiring a major software migration.
Which payers do you support?
We support major commercial payers, Medicare Advantage plans, Medicaid MCOs and regional carriers.
Do you handle denial appeals?
Yes. We prepare first-level appeals with supporting documentation and payer follow-up.
Is Svizzera HIPAA compliant?
Yes. HIPAA-focused processes and Business Associate Agreements are provided during onboarding.
Ready To Eliminate Authorization Bottlenecks?
Let’s discuss how Svizzera can reduce administrative burden and accelerate approvals.