prior authorization

ABD Medical is a Durable Medical Equipment (DME) and medical supplies provider based in Dayton, Ohio, serving patients, caregivers, and healthcare providers across Ohio and the United States. It offers wound care, diabetic care, diagnostic equipment, mobility aids, daily living aids, incontinence products, and more, with insurance verification, prior authorization, and documentation support. It is HQAA and BBB accredited and works with Medicare, Medicaid, and various insurance plans.

distributiondocumentationface-to-face serviceinsurance verificationnationwide shipping

Agape's Way Healthcare Services is the licensed clinical team operating inside four Kinbridge Living residential homes across Orange and Seminole Counties in Central Florida. It provides skilled nursing, therapy, and coordinating physician services for medically complex children ages 3–21, young adults 18–24, and adults 25 and older, in home-like settings. The company also offers skilled home health services in private residences throughout Central Florida.

24-hour clinical staffingAPD coordinationcoordinating physician servicesHome healthMedicaid waiver navigationoccupational therapyphysical therapyskilled nursingspeech-language pathology

AmeriHealth Caritas Louisiana is part of the AmeriHealth Caritas Family of Companies, a national leader in managed care. It provides access to quality health care to people covered by publicly funded programs, including Medicaid and the Louisiana Children's Health Insurance Program (LaCHIP). The company uses a coordinated approach to health care, leading-edge technology solutions, and innovative community programs, with the goal of improving health outcomes for members and building healthy communities across Louisiana.

behavioral health servicesclaims and billingcommunity health programsmanaged carepharmacy benefits managementpreventive care

Anovo (AnovoRx) is an independent rare disease specialty pharmacy headquartered in Memphis, Tennessee, providing nationwide support for rare and ultra-rare disease therapies. It offers an integrated Hub, 3PL distribution, and specialty pharmacy model for drug manufacturers, patients, and healthcare providers across all 50 states, including Early Access Programs, patient assistance, prior authorization, and direct-to-patient delivery.

3PL distributionadherence managementclinical assessmentdirect-to-patient deliveryEarly Access Programspatient assistancepatient services hubreimbursement supportspecialty pharmacy

Availity is described as the nation's largest dual-sided, real-time healthcare information network, connecting payers, providers, and health IT vendors to securely exchange information. The company facilitates over 13 billion clinical, administrative, and financial transactions annually and provides a platform for workflow automation, network connectivity, and interoperability across eligibility, authorizations, claims, and payments.

clearinghouseFHIR APIshealthcare information networkinteroperabilityrevenue cycle managementtransaction processingworkflow automation

BreakthruAI Corp is a physician-led medical billing and administrative services firm serving independent practices across the United States. Founded by Divesh Wadehra, MD, it handles billing, prior authorizations, referrals, refills, credentialing, and AR recovery, and also creates AI-driven software to enhance healthcare efficiency and reduce provider burnout.

appealsAR recoverycharge entryclaims submissioncredentialingcustom software developmentdenial managementeligibility verificationMedical billingpayment postingprescription refill supportreferral managementunderpayment review

CGS Administrators, LLC (CGS) is a Medicare Administrative Contractor (MAC) for the Centers for Medicare & Medicaid Services (CMS), and it is part of BlueCross BlueShield of South Carolina's Celerian Group of companies. Around 1,000 CGS employees provide a variety of services for over 28 million Medicare beneficiaries and 105,000 health care professionals across 38 states.

appealsclaims processingcustomer supportmedical reviewoverpayment recoveryprovider enrollmentredeterminationsreopenings

Fuse Oncology grew out of Cone Health in 2021, bringing clinical experience and software development together around the needs of radiation oncology. Its platform connects a clinical workflow for the care team with administrative tools for authorization, charge capture, and performance, integrating with existing EMR and OIS systems. The company's mission is to enable health providers to move from consult to treatment in just 24 hours.

AI-generated documentationcharge captureclinical consultingclinical workflow softwareinteroperability/integration with EMR and OIS systemsperformance analytics