Managing Prior Authorization is a pain area for providers with the changing landscape in US healthcare. Outsourcing of medical billing has been a prominent practice with most providers today. Ensuring quality balances with a complete practice management is the way forward.
Safeguarding the rights of beneficiary with the DMEPOS ruling emphasizes on consistency with prior authorization methods. Access to medical care is of prime significance and CPAP services will need to have a comprehensive benefits check process in place.
Understanding of insurer guidelines and allegiance to the prescribed process for procedures, diagnosis and drugs is the key. Competent prior authorization entitles you to with a concrete process managing denials. It will also be significant to observe that with prior authorization for CPAP as well as BiPAP machines, eligibility verification and authorization will be the focus. Hence, it is well assumed that a guided practice administration will serve as a genuine lifeline for DME providers.
Companies with a comprehensive understanding of insurer credentialing should be worth considering! They have a disciplined approach and process innovation with a pool of expert billers serve excellent value proposition. To achieve better ROI, you have to invest with a clear strategy on how you want to upgrade your practice management.
If you are looking to stay competitive with a well-knit revenue cycle management in place, partner with a billing company that will evolve your pre-authorization needs. Effective relationship management with insurers should be the road-map that eliminates rejections enabling better profits and focus on patient care.
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