Understanding the Operational Advantages in Prior Authorization Outsourcing Services

June 09,2016 / By Som Chaudhuri

Som Chaudhuri

Understanding the Operational Advantages in Prior Authorization Outsourcing Services

The increasing advancements in medical science are making the Healthcare industry more dynamic than ever. There are enormous changes happening in diverse segments that are constantly changing the dimensions of the industry in one way or the other.

One of the notable aspects is the guideline alterations of the insurers with legislation amendments within the state legal framework. It is precisely for this reason that practice management has become even more important than before!

Pedestal to practice management

~ Prior Authorization is truly the cornerstone of healthcare business & its effective management is of prime importance

~ Today, we find individual practices spend countless hours in benefits verification that can divert the focus from the patients

~ It often becomes catastrophic as an expenditure of huge finances with precious time gets a little result as an in-house team may not possess the necessary skill-set to overcome Payor objections to benefits verification

Prior Authorization Outsourcing services can be of excellent value for the providers who are looking to adopt a synchronized practice that gets a quick response with a balanced denial management process in place.

Some of the key benefits that are addressed:

~ Focus on care management: Increasing competition asks you as a diligent healthcare provider to focus on a patient care model. By effective Prior Authorization Outsourcing services, you will be able to adhere to the original medications that you prescribed to patients with simultaneous maintenance of insurer’s guidelines.

~ Operational cost cutting: One of the key attributes is that you can now free your employees without any hassles & cut down on expenditure on new hires or training. Your priorities will be in safe hands with the outsourcing vendor who will provide flexible engagement models much lower than your in-house costs.

~ Extensive experience of quality: The robust infrastructure & the technology platforms used by the vendors help you get the desired automation. The vendor resources have an extensive understanding of the insurer’s claims adjudication process that allow them to take care of your authorization needs in a disciplined manner.

Healthcare outsourcing companies are well aware of the correct methodology & quality adherence like HIPAA compliance that allows them to provide you comprehensive Prior Authorization service.


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