Pre Authorization

Secure Revenue Before Care Begins.

We focus on execution not theory so providers can spend more time on patients while we handle the operational complexity behind the scenes.

Omni Proactive Authorization Engine

Replace manual follow ups with a tech enabled system designed for Omni health care efficiency.

Rapid Turnaround Time

We don't wait on hold. Using AI driven status checks and direct payer portal integrations, we reduce authorization turnaround times by an average of 45%, preventing procedure delays.

Clinical Assembly

Our clinical experts assess medical necessity in alignment with payer guidelines such as InterQual and Milliman, compiling a complete and accurate clinical packet to substantiate the case.

Denial Prevention Engine

We stop denials before they happen. Our Omni AI tracks payer rule changes in real time, instantly flagging missing information or outdated CPT codes to protect your revenue cycle.

Complex Specialty Focus

Built for high cost complexity. We specialize in authorization heavy fields like Oncology, Cardiology, and Orthopedics, managing the specific nuances that generalist teams miss.

Pre Authorization Workflow

Intake & Verification

We instantly capture procedure details from your schedule, verifying patient eligibility and specific payer rules to determine authorization requirements.

Clinical Assembly

Our clinical experts validate medical necessity against payer guidelines (InterQual/Milliman), assembling the precise clinical packet needed to prove the case.

Direct Submission

We submit via real time web portals or EDI. We don't just submit and forget we actively monitor status daily, escalating delayed cases immediately.

Denial & Appeals

If a denial occurs, we initiate the appeal instantly. We even schedule and prep your providers for Peer to Peer reviews to overturn adverse decisions.

Testimonial

Our Client Happy Say

“ I believe in lifelong learning and kola is an great any more learn as recommend all my friends “

Leslie Alexander

President of Sales

“ I believe in lifelong learning and kola is an great any more learn as recommend all my friends “

Jibla Alexander

President of Sales

“ I believe in lifelong learning and kola is an great any more learn as recommend all my friends “

Jibla Alexander

President of Sales

“ I believe in lifelong learning and kola is an great any more learn as recommend all my friends “

Leslie Alexander

President of Sales

“ I believe in lifelong learning and kola is an great any more learn as recommend all my friends “

Jibla Alexander

President of Sales

REVENUE PROTECTION

Safeguarding Revenue for Leading Omni Health Care Systems

Don't let administrative friction delay patient care. We help our partners achieve a 98% First Pass Approval Rate, securing millions in revenue that would otherwise be lost to denials and write offs. Our health care system approach ensures your providers focus on medicine, not paperwork.

Partners Retention
98% Renewal Rate Among CFOs

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omni@kloud7.com

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    Frequently Asked Questions About Pre Authorization

    Have questions about protecting your Omni health care revenue? We address common inquiries regarding denial prevention, turnaround times, and clinical expertise to help you stop revenue leakage.

    We work directly within your existing Omni health care EHR (Epic, Cerner, Athena, etc.). We document the authorization number and validity dates directly into the patient chart, so your front desk sees the "Approved" status in real time.

    While it varies by payer, our health care system approach typically secures approvals within 24 to 48 hours for standard cases and <4 hours for STAT requests, preventing schedule delays.

    We have a specialized team for Retro Auths. If a patient comes in for an emergency or an add on procedure occurs, we aggressively pursue retroactive approval within the payer’s filing window to save the claim.

    Yes. We initiate appeals instantly upon denial. For clinical denials, we summarize the medical necessity argument and handle the scheduling logistics for your provider to conduct a successful Peer to Peer review.

    Our teams are trained in specific CPT nuances for high cost specialties, such as Oncology, Cardiology, and Orthopedics, ensuring accurate coding and medical necessity validation regardless of the department.

    Omni by Kloud7 helps health systems stabilize patient access, close mid office gaps, and prevent revenue loss before it reaches billing. Built for patient access leaders, operations teams, and healthcare executives managing complexity at scale.

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