Prior Authorization

prior authorization

When planning for Medicaid in-patient services, obtaining prior authorization from the state or the state’s contracted provider is complex and time consuming. Adreima saves hospital case managers’ valuable time. Our centralized team of skilled clinicians, registered nurse auditors and certified coders conducts medical necessity reviews concurrently to coordinate authorizations. In addition, the team conducts retrospective reviews to appeal denied days or secure authorizations on newly covered Medicaid recipients.

The results are quicker access to cash and a decrease in denials.

  • By applying our proven and vast clinical expertise, we ensure authorization for medically necessary care.
  • Adreima helps providers offer cost-effective care by correctly documenting the level of care the first time. Doing so assures that the right patient is in the right setting for the right number of days.
  • The results are quicker access to cash and a decrease in denials.
  • The unique perspective of our 200 clinicians, including specialized nurses and physicians, provides clinical evidence and reasoning for medical authorization of care that withstands challenge.
Adreima is pleased to announce that it has been acquired by nThrive. nThrive is a growing industry leader that leverages technology, services, education and analytics to create complete Patient-to-Payment℠ capabilities that our clients need.

Please view our press release for additional information about this exciting acquisition.