Prior authorization
Prior Authorization, Assembled and Tracked for Multi-Location Groups
When a payer requires sign-off before treatment, Ventus assembles the request to that payer’s requirements and tracks it until the determination is back.
Procedure pre-authorization, for dental and medical coverage.
- 300+
- payers normalized
- Dental
- procedure pre-auth
- Medical
- procedure authorization
Ventus is live in 400+ offices.
Prior authorization automation
Complete the first time.
Followed to an answer.
Prior authorization software that assembles each request, tracks it to a determination and puts the result in your chart.
01Assembled
Built to the payer’s requirements.
Codes, attachments and a clinical narrative, put together the way this payer asks for them.
Verification already flags which procedures need sign-off.Implant, lower right.
Pre-authorization required- Procedure codes
- D6010 · D6057 · D6058
- Tooth
- #30
- Radiographs
- Periapical · panoramic
- Periodontal chart
- Attached
- Clinical narrative
- Written to payer criteria
Assembled to what this payer asks for.
02Tracked
Followed until the answer is back.
Every request is tracked with the payer until the determination comes back.
Missing information goes to a person, not into a guess.From request to determination.
Approved- Requirements
- Matched to this payer
- Request
- Submitted with attachments
- Payer
- Received · under review
- Determination
- Approved
- Reference
- PA-4471-0923
Tracked until the payer answers.
03Written back
In the chart. Before treatment.
The determination and reference number go back into the systems your team already uses.
Writeback follows your group’s configuration.Ready for treatment.
Determination
Approved codes and the reference number.
Request notes
What was sent, and when.
Supporting documents
The attachments that went to the payer.
Implant, lower right.
Pre-authorization required- Procedure codes
- D6010 · D6057 · D6058
- Tooth
- #30
- Radiographs
- Periapical · panoramic
- Periodontal chart
- Attached
- Clinical narrative
- Written to payer criteria
Assembled to what this payer asks for.
Connected to your operations
Back in the systems
your teams know.
Determinations, reference numbers and supporting documents, written back into your practice management system. Configured for your group.
Explore integrations
Dentrix Ascend & Enterprise
Pre-authorization results, with configured writeback.
Open Dental
Determinations in your existing workflow.
Denticon
Your group’s fields, notes and attachments.
ModMed
Authorization for specialty-care workflows.
Ventus works through the system’s interface. Writeback does not depend on a vendor API.
One layer, not another point tool
Connected to
the rest of the cycle.
Before the request:
verification flags it.
Insurance verification returns whether a procedure needs pre-authorization, alongside the rest of the patient’s benefits. The request starts from what verification already found.
Insurance verificationAfter the determination:
the claim goes out.
Claims are prepared with their attachments, scrubbed and submitted, with a hand-off to a person when a claim needs manual review.
Claim submissionA rollout that fits your group
One setup.
Across your group.
One central setup, with about a month to go live. Start with your payers, systems and authorization volume.
Discuss your rollout and pricing- 01
Define the workflow.
Agree on which procedures, payers and documents are in scope, and what is written back. Compare the work removed, the work remaining and the proposed fees.
- 02
Connect the group.
Provide authorization, business associate agreements and practice-owned payer credentials where required.
- 03
Go live, centrally.
About a month for your group. About a week for a new payer. Ventus normalizes data from 300+ payers.
A closer look
Before
you decide.
More on scope, systems and the work your team keeps.
Read the buyer’s guideWhat are the best software solutions for automating prior authorization?
Judge them on four things: whether each request is assembled to that payer’s requirements, with codes, attachments and a clinical narrative; whether requests are tracked until the determination is back; whether the determination is written back into your practice management system; and where a person takes over. Ventus handles dental and medical procedure pre-authorization this way, for multi-location groups, on the same payer intelligence layer as insurance verification.
Does Ventus handle both dental and medical pre-authorization?
Yes, for procedures. Ventus handles dental procedure pre-authorization and medical procedure authorization. Drug and biologic prior authorization is not supported.
Which prior authorization tools support oral surgery across dental and medical insurance?
Look for one workflow that covers dental and medical procedure authorization, so a case billed to both plans is not split across two tools. Ventus handles both. Bring your oral-surgery procedure codes and payer mix to a demo to confirm coverage for your cases.
Which systems does it work with?
Ventus writes back into Dentrix Ascend, Dentrix Enterprise, Open Dental and Denticon, as well as ModMed. The agent works through the practice management system’s interface, so writeback does not require a vendor API. What is written back is configured for each customer.
What does our team still need to do?
Clinical decisions stay with your providers. When a request needs information that is not in the chart, it goes to a person on your team with what is already assembled, rather than being guessed.
How long does a multi-location rollout take?
Plan for about a month, with one central setup for the group. Your group provides written authorization, business associate agreements and practice-owned payer credentials where required. A payer not yet covered goes live in about a week.
How is prior authorization software priced?
Contact sales for pricing. Start with your current authorization volume and the staff time it takes, then compare the work removed and the work that remains alongside the proposed fees.
Your payers. Your systems.
Let’s make it work
for your group.
Walk through your authorization workflow with us.