Retro authorization, also known as retrospective authorization or retroactive authorization, is the process of get approval from an insurance payer after a medical service has been provided. It is usually used when pre-authorization was not obtained due to emergencies, missed notifications, or administrative delays.
Prior authorization, which occurs before treatment, retro authorization involves submitting documentation post-service to prove medical necessity and seek payment approval.
In healthcare, retro authorization means submitting clinical documentation and justification to an insurance company after treatment.
This allows the payer to determine whether the service met coverage criteria and qualifies for payment.
It’s commonly used in:
Retro authorization acts as a safety remaining for billing departments and helps practices maintain healthy cash flow within the revenue cycle management (RCM) framework.
Fill out the form below and we’ll contact you shortly.
Each payer has different timelines for retro authorization.
Such as:
Always confirm timelines through the payer’s policy or provider manual.
Retro authorization serves as an important safety measure in medical billing and RCM, help providers recover revenue that might otherwise be lost due to missed or delayed prior authorizations.
By applying preventive measures, maintaining detailed documentation, and partnering with billing experts, healthcare practices can improve compliance, streamline workflows, and protect their financial health.
Contact Cures Medical Billing today to streamline your retro authorization process and protect your revenue.
Retrospective authorization refers to obtaining approval from an insurer after a healthcare service is rendered. It’s often used when pre-authorization wasn’t possible.
Expert billing companies handle documentation, payer communication, and appeals to secure retroactive approvals and minimize lost revenue.
Time limits vary by payer, some allow 30 to 90 days after the service date, while others may not accept retro requests at all.
In health insurance, “retro” means backdated or after the fact, referring to approvals granted post-service.
A backdated authorization is another term for retro authorization, approval given after the service date.
Yes, but approval depends on payer policies. Some eviCore-managed plans accept retro requests under strict criteria.
Prior authorization happens before treatment; retro authorization occurs after the service.
Yes, Both insurers allow retro authorization forms under specific conditions, typically within their time frame.
Discover Cures Medical Billing Services Across Different States
FL
NY
ML
CO
NJ
AZ
TX
CA
WA
We are a team of national medical billing service experts based in Astoria, NY, committed to providing ongoing value to our customers. We leverage technology and implement best practices to provide high-quality and cost-efficient medical billing solutions from domestic locations, enabling customers to achieve their business goals. Cures Medical Billing is the best option for any medical billing needs.
Medical billing around Astoria, NY, and beyond is our core competency and our specialists will efficiently manage all your billing needs. Our medical billing specialists have over 12 Plus years of experience with all security technologies to ensure data integrity for our customers. Using our medical billing service, anyone can make their medical billing task less resource-consuming.
Discover unparalleled efficiency and precision in healthcare financial management with Cures Medical Billing Solutions.
