While the Prior Authorization (PA) programs are complex and require a lengthy process for approval, it is important to control costs and to provide the right treatment solution. To reduce the burden The American Hospital Association, Blue Cross Blue Shield Association, AHIP, the American Pharmacists Association and MGMA all of them have come to a conclusion in decreasing the prior authorization burden by signing the 2018 Consensus Statement on Improving the Prior Authorization Process. The statement includes
- Applying selective prior authorization requirement
- Frequently checking and eliminating pointless prior authorization process,
- Importance to be given on continuity of treatment for patients care
- Communicating should be the key
- Ensuring transparency and usage of EPA
Another step for easing the prior authorization is outsourcing. Outsourcing not only helps in reducing the overhead cost in the process but also provide complete transparency along with streamlined operation.
Now The Question Arise which Outsourcing Organization to Choose?
PriorAuth Online powered by Sunknolwedge Service Inc a medical billing solution is a perfect fit for such outsourcing partner, with a 100% prior authorization submission on the same day. Sunknowledge prior authorization works starts with collecting the required vital information of the medical procedure, patient, and provider and then verifying and validating prior auth request with effective payer side communication. This is followed by checking the patient’s eligibility and then initiating the auth request based on the payer mandates. This at the end ends with checking the auth status and updating the auth income in the PM/Billing system that also with 80% reducing in your operational cost.
- 100% HIPAA and HITECH compliance with 24*7 dedicated account manager
- Robust reporting providing daily/weekly/monthly report according to the client’s protocol.
- 97% first pass collection rate
- 99.9% billing and coding accuracy rate
- Unparalleled operational transparency with the highest productive metric
- No write-offs or adjustment are claims without the client’s consent
- Hiscox Insurance covers of $1 million for Errors of Omission and Commission
So if you are looking for an effective faster prior authorization process ‘PriorAuth Online’ is the perfect operational extension easing your entire authorization problem. For more details on prior authorization call Sunknowledge expert over a ‘no commitment call‘.