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Prior Authorization

Prior Authorization from Soft Home Global costs $1,900 per seat per month. That is one full time trained person, forty hours a week, working United States business hours inside your own system. One seat, one month, cancel any time.

Submitted before the date of service and chased through the payer's decision window.

What the seat actually does

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

What it costs

$1,900

Per seat, per month, in US dollars. Full time, forty hours a week, on US hours — not per hour, not per claim, and never a share of your collections.

Compare against the other 21 roles →

The denial codes this seat works

7 codes, grouped the way the queue is worked rather than by number. Each one links to what causes it, the order to work it, and how to stop it recurring.

Worked by being taken back to the authorization

CO-197 — Prior authorization absent
The payer required prior authorization for this service and cannot find one attached to the claim.
CO-15 — Authorization number missing
There is an authorization requirement here, and the number you sent is absent, wrong, or does not cover what was billed.
CO-39 — Authorization already refused
The authorization was asked for and refused, and the service was delivered anyway.
CO-272 — Coverage guidelines not met
The service is covered in principle but this instance did not meet the programme’s conditions.
N54 — Claim does not match the authorization
There is an authorization, and what was billed does not match what it covers.

Worked by being answered with the document the payer names

CO-198 — Authorization limit exceeded
An authorization exists. The problem is that you went past what it allowed — more units, more visits, or a longer date range than was approved.

Worked by being appealed with clinical documentation

CO-273 — Guidelines exceeded
The service is covered, but this instance went past a programme limit: more visits, units or sessions than the guideline allows.

Working a denied claim costs $57.23 per denied claim in administrative time (source) and about about 90% of initially denied claims are eventually paid. The reason they sit is almost never that nobody knows how. It is that nobody has the hours.

How a seat starts

You issue one named login. We sign the Business Associate Agreement before it is used. We agree the numbers you will judge the seat on, which you pick and you measure. Then we train for about a week on your workflow and the seat starts. Every Friday you get a written report of what was done, what the numbers were, and what went wrong.

The four steps in full →

Questions

How much does prior authorization cost?

$1,900 per seat per month. That is a full time person, forty hours a week, working United States business hours. Not per hour, not per claim, and not a percentage of what you collect.

Is there a minimum contract?

One seat for one month, cancellable with thirty days notice. There is no annual lock-in.

Do we have to change systems?

No. The work happens inside whatever you already use, through a named login you issue. We do not sell software and we do not route your data through anything of ours.

How quickly can a seat start?

About a week from the agreement, which covers training on your workflow, your payer mix and your system. You are not charged extra for that week.

Written by Ibtesam Asif · Last reviewed 2026-09-12

Prices and terms on this page are our own published terms and are what we will actually charge. Nothing here is a projection of what a practice will collect.

Next step

Try one prior authorization seat for a month

$1,900 for the month. If it does not earn its keep, cancel it. Twenty minutes on a call is enough to tell whether it fits.

Book a 20 minute call See the prices

Or write to ops@softhomeglobal.com