Getting pre-approval is still a challenge with major healthcare providers. In today’s scenario and looking add the approach of the present administration, there will be some serious changes that will impact a provider’s daily collections. It is a well-known fact that enormous amount of time and money is spent by providers every year to get their prior authorization process right!
How to rectify your eligibility verification process? What will be the immediate need for you to reduce time in getting your first time PA requests? Do you have the answers and the vision ahead to employ the right strategy in practice management?
The pertinent fact is with the changes expected in insurance mandates, it will be critical to stay ahead in the competition with equipped processes helping you improve your verification needs. You will be needed to find a match between your benefits check and consistency in denial management. Managing rejections, in the long run, will be possible if you set the tone with a quality cost management practice. A streamlined prior authorization will help in eliminating risks with rejections and also improve your collections.
To cover specific services, getting the right agreement that will guarantee a standard procedure will also give you clarity. Some of the services will also be valid for a set time and a periodic process of re-approval will be necessary. Any professional in the medical billing world and is proactive will be telling you the real time benefits you can expect with streamlined pre authorization.
Reducing costs in operations and the time frame in getting approvals will need smart automation and use of disruptive technology interfaces. Also, it will be the resources in medical billing that will be using the platforms to generate consistent reimbursements for you!
While you look for expert intervention, it will be indispensable for you to find someone that has been catering solutions with competitive credentials. It is true that there are a lot of medical billing companies but to find the right partner, validating their best practices will be a key step!
Unique approach and what are the present standards in revenue cycle management will be an important checklist. Does the vendor know how to optimize your collections by ensuring the right checks and balances?
Managing all the aspects of prior authorization will need effective communication between the insurers and the provider. The need of the hour will be to find a next gen billing company that is compliant in their processes and provide state of the art revenue cycle management services by connecting all the checkpoints with seamless platforms.
The Sun Knowledge Success Story
In a medical procedure, obtaining prior authorization especially for a quasi-medical product like Botox can be taxing. A good deal of proactive follow-up and complete knowledge about the payer guidelines is a critical step.
Sun Knowledge surely rose up to the occasion and helped in developing a successful liaison between the insurance, the prescribing physician and the specialty pharmacy.
They helped in securing maximum payment and right from gathering documents from the provider and contacting the insurance company, to successfully updating the authorization in the billing system of the client, they did it all!
Also, they helped in scheduling the delivery of the drug by calling up the specialty pharmacy with excellent reporting standards.
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