Prior Authorization in Kentucky
Soft Home Global provides authorizations submitted ahead of the date of service and chased to a decision for Kentucky practices and billing companies at $1,800 per seat per month. Full time, worked during Kentucky business hours, inside your own system.
What is specific to Kentucky
Kentucky expanded Medicaid early and enrols most members with a small set of managed care organizations, while Medicare Advantage enrollment runs high statewide and Humana is headquartered in Louisville.
Kentucky’s Medicaid programme is Kentucky Medicaid. Practices with a meaningful Kentucky 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 Kentucky
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 Kentucky 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 Kentucky business hours, not queued overnight
For the statute behind all of this — Kentucky’s prompt-pay deadline, its Medicaid filing limit, and the wrinkle that catches people out here — see the Kentucky billing page.
Working Kentucky hours
Kentucky runs on Eastern time, 10 hours behind our floor in Rawalpindi. To be at a desk for your nine to five, the shift here runs 7pm to 3am, and 6pm to 2am 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 western half of the state runs on Central time. 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 Kentucky hours and nobody else’s.
What it costs in Kentucky
$1,800
Per seat, per month, in US dollars — $21,600 a year for one full-time person, forty hours a week, on Kentucky hours. No annual contract, no percentage of collections, no setup fee and no software to buy. Seat prices across all roles in Kentucky run $1,450 to $2,400; 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 Kentucky
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 Kentucky practices?
Yes. Kentucky accounts are worked during Kentucky office hours rather than queued overnight, because a payer's phone lines are open then and at no other time.
What is different about Kentucky?
Kentucky expanded Medicaid early and enrols most members with a small set of managed care organizations, while Medicare Advantage enrollment runs high statewide and Humana is headquartered in Louisville.
How long do we have to file a Kentucky Medicaid claim?
12 months from the date the service was rendered, measured from the date the service was rendered. Not stated in the section quoted. Past that date a claim is not late, it is unpayable, and no appeal recovers it. Source: 907 KAR 1:673 — Medicaid claims (timely filing).
When does a Kentucky payer have to pay a clean claim?
30 calendar days for a clean claim, paper or electronic alike (no electronic/paper split); 60 days for organ transplant claims 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 Kentucky?
$1,800 per seat per month — $21,600 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 Kentucky queue?
Kentucky is on Eastern time, 10 hours behind Rawalpindi. The shift here runs 7pm to 3am so your seat is at a desk for your full working day, shifting to 6pm to 2am while daylight saving is in force — Pakistan does not observe it, so the change happens on our side.
Do you handle Kentucky Medicaid as well as commercial payers?
Yes, and as its own queue rather than mixed into commercial follow-up. Kentucky 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 Kentucky 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