Prior Authorization in Alaska
Soft Home Global provides authorizations submitted ahead of the date of service and chased to a decision for Alaska practices and billing companies at $2,000 per seat per month. Full time, worked during Alaska business hours, inside your own system.
What is specific to Alaska
Alaska pays Medicaid on a fee-for-service basis rather than contracting with managed care organizations, and a large share of care runs through the tribal health system under Indian Health Service billing rules.
Alaska’s Medicaid programme is Alaska Medicaid. Practices with a meaningful Alaska Medicaid mix usually need it worked as its own queue rather than mixed into commercial follow-up, because the submission path, the timely filing window and the appeal route are all different.
What a prior authorization seat does in Alaska
Submitted before the date of service and chased through the payer's decision window.
An authorisation found after the visit is a write-off, not a denial to appeal. In Alaska the work is submitting ahead of scheduling and chasing the decision, against a payment clock that starts only once a clean claim lands.
- Authorizations submitted ahead of scheduling, not after
- Status chased rather than waited on
- Peer-to-peer reviews scheduled when required
- Clinical documentation gathered before submission
- Expiring authorizations flagged before they lapse
- Worked during Alaska business hours, not queued overnight
For the statute behind all of this — Alaska’s prompt-pay deadline, its Medicaid filing limit, and the wrinkle that catches people out here — see the Alaska billing page.
Alaska Medicaid, in practice
Entirely fee-for-service — Alaska contracts with no comprehensive Medicaid MCOs (KFF 2024 MCO enrollment = N/A; "N/A: Not applicable. State had no contracts with comprehensive MCOs."), so there are zero health plans between the provider and the state. Source
Because of geography, Alaska Medicaid pays for patient travel as a covered benefit and devotes an entire regulatory article to it — 7 AAC 120 Article 3 contains "§ 7 AAC 120.405 - Transportation and accommodation covered services", "§ 7 AAC 120.410 - Prior authorization for nonemergency transportation services", "§ 7 AAC 120.425 - Accommodation services", "§ 7 AAC 120.430 - Authorized escort" and "§ 7 AAC 120.435 - Prematernal home services". Alaska billers routinely handle lodging, escort and air-travel authorizations that do not exist in most states. Source
For authorisations it decides who you ask. A carve-out means the rules, the portal and the turnaround belong to a different administrator from the one handling the rest of the member’s care, and an authorisation obtained from the wrong one is not an authorisation.
Working Alaska hours
Alaska runs on Alaska time, 14 hours behind our floor in Rawalpindi. To be at a desk for your nine to five, the shift here runs 11pm to 7am, and 10pm to 6am once the clocks go forward. Pakistan does not observe daylight saving, so the shift moves on this side rather than yours.
One wrinkle worth naming: the Aleutian islands sit an hour further west again. If your practice sits on that side of the line, say so on the call and the shift is set to your clock rather than the one most of the state keeps.
That is the part that decides whether follow-up happens at all: a payer’s phone lines are open on Alaska hours and nobody else’s.
What it costs in Alaska
$2,000
Per seat, per month, in US dollars — $24,000 a year for one full-time person, forty hours a week, on Alaska hours. No annual contract, no percentage of collections, no setup fee and no software to buy. Seat prices across all roles in Alaska run $1,600 to $2,650; the full list is published.
That is the entire invoice. Run your own figures against a percentage vendor or a hire rather than take ours.
Getting started in Alaska
About a week from a signed agreement to a person working your queue, and that week of training on your workflow is not billed on top. The work happens in your own system under a login you issue, so there is nothing to migrate and nothing to install. The week, step by step, and what is signed before anyone has access.
Questions
Do you work with Alaska practices?
Yes. Alaska accounts are worked during Alaska office hours rather than queued overnight, because a payer's phone lines are open then and at no other time.
What is different about Alaska?
Alaska pays Medicaid on a fee-for-service basis rather than contracting with managed care organizations, and a large share of care runs through the tribal health system under Indian Health Service billing rules.
When does a Alaska payer have to pay a clean claim?
30 calendar days after receipt of a clean claim. No electronic vs paper split. If the insurer requests information within that window, it must pay within 15 calendar days of receiving the information or within 30 days of the claim. A claim sitting past that is not merely late, it is late against a statute, and the follow-up call changes from "when might this be paid" to "this passed your statutory window on a specific date".
How much does prior authorization cost in Alaska?
$2,000 per seat per month — $24,000 a year for a full-time person, forty hours a week. Every seat price is published at softhomeglobal.com/pricing.
What hours will somebody actually be working our Alaska queue?
Alaska is on Alaska time, 14 hours behind Rawalpindi. The shift here runs 11pm to 7am so your seat is at a desk for your full working day, shifting to 10pm to 6am while daylight saving is in force — Pakistan does not observe it, so the change happens on our side.
Do you handle Alaska Medicaid as well as commercial payers?
Yes, and as its own queue rather than mixed into commercial follow-up. Alaska Medicaid has its own submission path, its own filing window and its own appeal route, and working it in the same worklist as commercial claims is how the deadlines get missed.
Is this a percentage of what you collect?
No — a flat monthly rate per seat, published at softhomeglobal.com/pricing. A percentage bills you most in your best month and points the vendor at the easy accounts.
What is the minimum commitment, and how quickly can somebody start?
One seat for one month, cancellable on thirty days notice, and about a week from a signed agreement to a person working your queue. The week of training is not billed. The steps are at softhomeglobal.com/how-it-works.
Is our patient data safe offshore?
A Business Associate Agreement is signed before anyone has access, and the work happens in your own system under a login you issue, so every action is attributable to a person in your audit trail. The controls are listed at softhomeglobal.com/security.
Next step
One seat on your Alaska work
Twenty minutes on a call is enough to tell whether this fits. If it does not, I will say so.
Or write to ops@softhomeglobal.com