Surgical Pre-Authorization Support
Ensuring approvals before procedures
Handling authorization logistics so employees can focus on preparing for surgery
Why does pre-authorization support matter?
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Insurance pre-authorization requirements have become increasingly complex. Procedures that should be approved get denied on technicalities. Forms get lost. Deadlines get missed. Weltrio handles authorization logistics to prevent surprises on surgery day.
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See where your benefit plan is leaking
Find out what gaps exist — and what you can do without changing your plan.
We'll show you where money is leaking, risks are growing, and what you can fix within your current structure. No pressure to change brokers, carriers, or benefit design. Just clarity.
- Gap analysis based on your actual plan structure
- Clear findings you can share with your broker
- Recommendations that layer on — no disruption required
Authorization Navigation
We identify what authorizations your procedure requires, submit appropriate documentation, and track approval status. No more wondering if your surgery is actually approved.
Documentation Coordination
Authorizations require documentation—clinical notes, imaging results, prior treatments. We coordinate collection and submission of required materials.
Appeal Support
If authorizations are initially denied, we support the appeal process. Many denials are overturned with proper appeals—we know how to make them.
Cost Pre-Negotiation
Beyond authorization, we help understand expected costs and negotiate where appropriate before procedures occur. No surprise bills if we can prevent them.
What is Surgical Pre-Authorization Support?
Surgical Pre-Authorization Support manages the insurance approval process for planned surgeries and procedures.
Most health plans require pre-authorization for surgeries—approval before the procedure confirming that the insurance will cover it. This sounds simple but often isn't. Requirements vary by plan, documentation demands are complex, and denials happen even for medically necessary procedures.
Our support handles authorization from start to finish—determining requirements, gathering documentation, submitting requests, tracking approvals, and appealing denials when necessary.
Why Do Authorizations Go Wrong?
Most employers renew their health plans year after year without questioning the underlying assumptions. Brokers present options, carriers set rates, and leadership approves budgets based on incomplete information.
The result? Companies overpay for benefits employees don't use while missing coverage gaps that create real risk. They accept premium increases as inevitable rather than addressable. They lack visibility into where their money actually goes.
A Healthcare Risk Assessment changes that. It gives you the data and insight to make informed decisions, negotiate from a position of strength, and take control of one of your largest operating expenses.
How It Works
Pre-authorization support manages the approval process from decision through surgery.
Authorization Assessment
When surgery is recommended, we determine what authorizations are required by your specific insurance plan.
Documentation Gathering
We coordinate collection of required clinical documentation from your providers—ensuring all needed materials are available.
Submission & Tracking
We submit authorization requests and actively track status, following up with insurers to ensure timely processing.
Resolution
We confirm approvals, communicate coverage details, and handle appeals if initial requests are denied.
When Should Employees Request Authorization Support?
As soon as surgery is recommended:
• When a doctor recommends a surgical procedure
• When scheduling elective surgery
• When facing any procedure that may require pre-authorization
• When insurance has previously denied or delayed authorizations
Early engagement gives maximum time for authorization processing and any needed appeals.
Where Does Pre-Authorization Support Apply?
Authorization support applies to any procedure requiring insurance approval:
• Hospital surgeries (inpatient and outpatient)
• Ambulatory surgery center procedures
• Major diagnostic procedures (MRI, CT with specific indications)
• Specialty treatments requiring approval
We handle authorizations regardless of where the procedure will occur.
Who Benefits from Pre-Authorization Support?
Any employee facing a procedure that requires insurance authorization:
• Those scheduled for elective surgeries
• Employees needing urgent but planned procedures
• Anyone who has experienced authorization problems before
• People with complex insurance plans with extensive requirements
• Employees unfamiliar with the authorization process
See What Our Customers Are Saying
"What could have been data driven, was soon a conversation. Over 3 years with the best coaches, listeners, advisors you could ask for. If Monique didn't have an answer readily, she would note it, research it, and then update you on the answer. Always a positive meeting. Highly recommend!"
— Sue D.
“Our Medical Insurance Premiums were Out of Control! Thanks to Weltrio and their amazing team of healthcare experts, Weltrio is my single most-profitable cost center!”
— Cayuse CEO
Everything You Need to Know
At Weltrio, we are a medically trained team that works with HR and benefits partners at companies of all sizes to improve healthcare quality, reduce risk exposure, and optimize costs. We work within your existing plan structure—providing employers with clarity, trust, and transparency at every step. Whether you're upgrading your benefits plan or building from scratch, we've got you covered.
Is this the same as telemedicine?
No. Clinical support provides guidance and triage, not diagnosis or treatment. We help employees decide when and where to seek care.How many nurses will be assigned to our company?
Assignment depends on your company size and typical utilization. Smaller companies may share a primary nurse with backup coverage. Larger organizations get dedicated teams. Either way, employees experience consistent relationships with clinical professionals who know them.Who answers calls in the middle of the night?
Board-certified nurses from your Weltrio clinical team. We staff night shifts with experienced nurses who have full access to your company's benefits information and employee interaction history. It's not an outsourced answering service.What protocols do nurses use for triage?
Our nurses use evidence-based clinical decision support protocols developed from emergency medicine and primary care best practices. These protocols are regularly updated based on current medical guidelines and are customized for telephone/virtual assessment settings.How much does an unnecessary ER visit actually cost?
Average ER visits cost $2,200 or more—even for minor issues. Add lab work, imaging, or specialist consultation and costs climb quickly. The same conditions treated at urgent care typically cost $150-300, and telehealth visits run $50-75.
