Prior authorization is one of the most challenging areas in billing for ophthalmology practices. Ask any ophthalmologist about his chief deterrent in the process of generating a steady stream of revenue from his practice, and chances are, in 9 times out of 10, you’d get prior authorization as the answer.
So what is the hue and cry about prior authorization all about? Let’s cover the basics first. Prior authorization is a technique for minimizing costs. The aim of the prior authorization (PA) program is to ensure appropriate selection of services or medication for treatment, according to the disease concerned.
Hiring an expert for pre-certification eliminates different problems and eases the way for fast recovery of accounts receivable, which is a major concern for most providers. It also helps a provider to focus on his primary area of interest, viz. to render healthcare services, rather than getting involved too much in secondary administrative tasks.
The whole process of PA executed by an expert is always accurate and completed in time. This is ensured simply by the fact that a dedicated expert always keeps himself abreast of all the latest requirements by different Insurance agencies to pre-approve requests sent to them. Allowing an expert to handle all your prior authorization tasks also works wonders in actually increasing the number of requests getting approved while decreasing the time required for such a process.
A third party is also helpful in fetching the requisite information needed to complete the request, providing additional guidance like specifying what kind of supporting documentation is required for specific requests, or simply going that extra mile to follow up on a request already placed to ensure its quick resolution.
In the end, it is easy to see why a growing number of ophthalmology practices are opting for dedicated, third-party prior auth services. It just might be the best move available right now to cut cost, boost collection and get rid of a lot of prior-auth related worries.
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