OneMed's prior-auth desk checks the payer rule, builds the clinical case, submits, and chases the decision so care stays on schedule and denials never start.
Not filed and forgotten. Worked stage by stage, with records attached and payer rules applied before submission.
Coverage and benefits confirmed with payer reference numbers on file.
Matched against that payer's current medical-necessity policy.
Clinical documentation packaged to support the request first time.
Filed via portal, fax, or over-the-call, whichever the payer needs.
Followed up to an approval, with status visible to your team.
AI-assisted lookups plus experienced specialists on the clinical judgment. Speed without approvals slipping.
High-scrutiny requests need someone who knows the payer's playbook. Our deepest benches, though the full list runs well beyond them.
| Specialty | Typical auth volume | Payer scrutiny | What we handle |
|---|---|---|---|
CardiologyFocus |
High · imaging + procedures | High | Cath, device & imaging auths with medical-necessity docs |
Home HealthFocus |
High · episodic | Medium | Episode & visit auths tracked to timelines |
HME / DMEFocus |
Steady · equipment | High | Coverage-criteria handling for strict payer rules |
RPM · CCM · TelehealthFocus |
Recurring | Low | Time-based & recurring auth management |
Oncology |
High · infusion | High | Chemo, infusion & imaging pre-auths |
Orthopedics |
High · surgical | Medium | Surgical & injection auths with modifiers |
Start with a dedicated specialist, or pay only for the auths we clear. Both scale with volume, specialty, and complexity.
Need more than auths handled? OneMed covers all fifteen RCM services end to end, credentialing through A/R.
OneMed has truly been a game changer for our cardiology practice. Their team brought real value and made our billing smoother and more efficient.
Tell us your specialty and monthly auth volume and we'll return turnaround expectations and pricing on both models. No obligation.