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DrCatalyst provides full-time prior authorization specialists, which includes 80+ registered pharmacists. This includes routine prescriptions, high-cost biologics and infusions, as well as buy-and-bill therapies.
Talk with DrCatalyst About Medication AuthorizationsOur medication prior authorization services cover every stage of the approval process, from benefits and formulary checks to submission, follow-up, appeals, and renewals.
Our pharmacist-backed specialists prepare complete requests for dermatology, rheumatology, allergy and immunology, gastroenterology, oncology and hematology, neurology, pulmonology, and ophthalmology clinics, including step therapy history, lab values, and diagnosis documentation. We also handle reauthorizations and biosimilar requirements.
Your clinic buys high-cost biologics and infusion drugs in bulk. Our specialists verify each patient's coverage, review documentation for medical necessity, flag gaps for the provider, and secure the prior authorization so every administered dose gets reimbursed.
We gather information about plan coverage for weight loss medication such as BMI thresholds, related conditions, and documented lifestyle programs. Our specialists record this up front and track renewal timelines, so approvals don't lapse between refills.
Our team verifies formulary status, confirms each payer's clinical criteria, and pulls chart notes before sending a request. We follow up regularly with the payer until a decision is made. If you need an authorization on short notice, message your specialist directly for prompt attention.
Infusion therapies often need two approvals: one for the drug and one for the site of care. We coordinate both, including J-code documentation and site-of-care reviews, so your clinic can administer a high-cost drug once it's cleared.
GLP-1 coverage depends on whether a drug is prescribed for diabetes or weight management. Our team documents the diagnosis, supporting labs, and step therapy history for each request so your clinic's submissions meet each payer's current criteria.
Your outsourced team handles pharmacy benefit prior authorization requests for your clinic. They review rejections, gather the payer's requirements, and submit through ePA portals or the payer's preferred channel.
From missing chart notes to expired approvals, small gaps create big delays. Our pharmacists catch these issues before a request ever reaches the payer.
Most denials come from missing information. Our team checks each payer's criteria against your chart before submission and flags documentation gaps to your providers.
Payers often require proof that a patient tried other drugs first. We review prior therapies, dates, and outcomes so your clinic's requests meet step therapy rules.
When high-cost drugs are already on your shelf, a denial means absorbing the cost. We review documentation, flag gaps for the provider, and secure prior authorization before treatment, so stocked drugs get reimbursed.
Payers update formularies, preferred drug lists, and step therapy rules without much warning. We monitor these changes and adjust your clinic's submissions.
Approvals for biologics and specialty drugs expire, and missed renewals send requests back to the start. We track every renewal date and resubmit before approvals lapse.
Pharmacy rejections create phone tag between your staff, the pharmacy, and the payer. We manage the entire process for your clinic, from rejection to resubmission.
Prior authorizations pull clinical and front-office staff away from their core work. Our remote coordinators take on the full workload inside your EHR, without the cost of hiring in-house.
We find the root cause of denials, whether it's missing documentation, an unmet step therapy rule, or a formulary exclusion, then prepare the appeal and schedule peer-to-peer reviews when needed.
Approvals for biologics, specialty drugs, and GLP-1s often last only a few months. We track every expiration date and start reauthorizations early, and review updated clinical documentation for continuity in care.
Outsourcing medication prior authorization to DrCatalyst benefits your clinic with pharmacist-backed expertise without the overhead of hiring, training, and retaining on-site staff. Our team supports 60+ specialties and works in 84+ EHR systems.
DrCatalyst’s team moves quickly and the results are showing much, much faster than our previous credentialing company. We are extremely pleased; keep up the good work!
Adriana Hernandez
VP, Compliance, Revenue Cycle & MSO, STeM Management LLC
Colorado
Our DrCatalyst team has been such a great help! Our credentialing is running smoothly especially since this is all new to us.
Jennifer Perez
Office Manager NeoKids LLC
Louisiana
We’ve never had this quality of work before. The DrCatalyst team is extremely good; they are doing a fabulous job. They are quick and on the top of everything.
Dr. Hargrove
Medical Director Clinica Medica General
California
DrCatalyst has never let me down. It’s a great partnership opportunity.
Tushar Patel
MD Children’s Medical Centers of Fresno
California
We have grown to five DrCatalyst staff within six months – all members have become a part of our team in such a positive way, our staff enjoys communicating with them. Thank you all for all you do!!
Michelle Castilleja
Clinical Director Northeast Endocrinology
Texas
The payment posting and A/R team at DrCatalyst have been doing an amazing job with their tasks. We are very happy with their work ethic and appreciate what they have done and continue to do for our practice.
Vikram Shah
Billing Specialist, Children’s Medical Clinic
California
Your claim resolution and diligence allowed for a large number of claims to be worked and removed from Aging AR with receipt of payment for these services. We could not have done this without you!!!
Heather Richmond-Munyon
Practice Manager Milan Eye Center
Georgia
I can honestly say the teamwork exhibited by DrCatalyst is unmatched by any other billing team I have worked with in the past twenty-five plus years.
Diane Johnson
DPM, Owner
Pennsylvania
We are very pleased with the coding work you all have been doing. We sincerely appreciate all of their assistance and knowledge.
Felix Sigal
DPM Owner LA Foot Pain
California
I appreciate DrCatalyst for helping us transfer records! You are helping our WP location staff tremendously!
Tammy Ortiz
Director of Billing Global Neuro and Spine Institute
Florida
DrCatalyst’s contribution has made a very positive impact on our practice. I would highly recommend DrCatalyst for RCM services.
Rene Steven
Practice Administrator
Wisconsin
DrCatalyst has a dedicated team assisting your account, a partnership highly recommended for your RCM requirements. They are professional, responsive, and always consistent with providing support and feedback in a timely manner.
Zacharia Facaros
DPM Owner
Pennsylvania
We highly recommend DrCatalyst to organizations and independent physicians, particularly those in specialized fields or small practices.
Patrick Caplis
CEO Solvera Health
Illinois
We give your business the edge with unmatched features working seamlessly together, delivering precision and efficiency like no one else.
Written protocols Liability Insurance 3+ Levels of Supervision 5 point IT protection HIPAA BAA included Comprehensive reports & KPIs 3rd party HIPAA compliance certificationMedication prior authorization services manage the insurance approval process that clinics must complete before certain medications are covered. DrCatalyst handles benefits checks, documentation, submission, payer follow-up, appeals, and renewals for your clinic.
A medication prior authorization specialist verifies coverage, gathers clinical documentation from your EHR, submits requests to payers, follows up until a decision is made, and handles appeals when a request is denied. At DrCatalyst, our specialists are backed by 80 registered pharmacists and 3+ levels of supervision.
Yes. Specialty drug prior authorization is central to our work, including biologics, infusion therapies, GLP-1s, buy-and-bill drugs, and other high-cost medications that require reviewing detailed documentation and regular reauthorization.
Our medication prior authorization assistance includes formulary and benefits checks, documentation review, submission through payer portals or ePA, follow-up, denial management, appeals, peer-to-peer scheduling, and renewal tracking. We customize these steps to your clinic's workflow.
Our 80 registered pharmacists bring clinical insight to complex requests, especially biologics, infusions, and specialty drugs. They help make sure each request clearly shows medical necessity and meets the payer's clinical criteria.
DrCatalyst has supported medical practices since 2010 and has grown to a team of more than 1,600 people. Every account includes 3+ levels of supervision at no extra cost. If a specialist is out, a supervisor steps in so your authorizations keep moving without disruption.
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