Electronic Pre-Certification Management System

The Medical Consultants Group is introducing another way to help doctor’s offices use technology to save money and improve efficiency through a pre-certification system allowing a quicker approval from insurance companies.

Current Healthcare Pre-Certification Authorization Process

Currently, the process of receiving authorization for surgical procedures from insurance companies is very labor intensive.

Each insurance company has a specific form. These forms have to be filled out manually and submitted via fax.

Once the insurance company has received the form, a practice employee has to follow up to make sure the authorization is granted. It is not unusual for this employee to spend 30-45 minutes on the phone trying to get ONE authorization. This is especially true when for a high percentage of that time, the employee is probably on “HOLD”.

This system is frustrating for the employee, and is costly and stressful for the practice, who is waiting to get confirmation that their patient’s surgery will be approved and that they will in turn be paid.

In addition, consider all of the labor involved for someone at the practice to follow up. This follow up is usually done on a case by case basis with no central data repository for all pre-certification data.

Electronic Pre-Certification Management System

Exchange EDI’s new all-electronic pre-certification authorization portal allows practices to expedite the process of authorizing insurance approvals through two parts: submission process and approval process.

See an Example of the Pre-Certification Portal: Exchange Edi Electronic Pre-Certification Sample Report

Submission Process

Our Pre-Certification Portal gathers the appropriate information from your Practice Management and/or EMR software to populate the insurance companies’ forms. It then submits the forms electronically in either a batch or in real time.

By transitioning the process into all electronic forms, the practice employee’s time spent on submitting the request is reduced significantly. Not only is the submission simplified, but the follow up process is made much easier.

Approval Process

We create a central data repository for all authorization requests so the practice employee has only one place to look to see where each request stands and what has to be done to complete the process.


Listen to a interview from Gray Mason, the founder of the Pre-Certification Portal from Exchange Edi. Learn how the new software can expedite your billing approvals from insurance companies throughout the industry.

Benefits for Practices

This management system has benefits in addition to just increasing practice efficiency. It also gives the practice the ability to spot trends over time.

For example, one insurance company may be consistently denying one particular kind of request. Maybe one employee is consistently missing one piece of data on the submission. These kinds of situations will be illuminated by the management reports so the situation can be addressed.

A current practice utilizing the portal believes that their specialty surgical practice will be able to reduce the cost of the authorization process by 60%!

Call Medical Consultants Group for a Free Demo

The team at the Medical Consultants Group is anxious to help you understand how this new technology can help your practice cut costs, reduce frustration, increase practice profitability and improve the patient experience.

Speak with a representative at (404) 272-4883 today for a custom demo of the portal for your practice.