Key Points to Consider before You Choose to Outsource Prior Authorization

June 06,2016 / By Som Chaudhuri

Som Chaudhuri
prior approval

To cater to industry growth, prior authorization outsourcing cohorts have upped their sleeves to make it a thriving scheme. The committed workforces have an eye for detail, to make clients contented, relieved, and hassle-free through their prompt services. They are the ones to have an optimum knowledge and know several restraining factors of financial and menacing downsides. Often, in-house administration in hospital or physician’s clinic fails to grasp the necessities of their clients; similarly outsourcing prior authorization process through deft personnel lifts your healthcare business with meticulous execution.

Prior authorization is the process of getting an agreement or nod from the Payor to know about the coverage of specific medical treatments before physicians treat a patient. Normally, a Payor that authorizes a service prior to an encounter assigns an authorization number that you need to include on the claim when you submit it for payment.

To start offering flexible healthcare services to your client, one of the pre-requisite metrics is to become a sound player in the field of prior authorization and accomplish it through veritable medical billing outsourcing practices. Eliminating errors and submit clean claims, which are quickly processed and reimbursed the very first time they are submitted to the Payors, help to overcome the need for conventional in-house staffing. To bring true excellence in the claims submission process, in-depth competence is desirable to enhance the revenue cycle.

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Key points to ponder before outsourcing:

~ Primarily, prior authorization is a manual procedure which needs extensive scrutiny

~ Prior authorization approval is the leading constituent to commence and complete the process. If it has been outsourced to a competent medical billing company, your entire healthcare business will take a new shape, financially

~ Outsourced prior authorization personnel submit planned, succinct, and well-articulated application with supporting clinical information

~ Follow-up is the best solution to prevent delays, and Payor side experience gives an extra edge

Why should your administrative hassle take precedence over medical treatments? Countless reckoning of dollars could be taken care of and recovered if you appoint an ace medical billing company to do your claims processing and on-time payments to optimize profit levels.

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