Who’s Afraid of Prior Authorization?

Face-off with Prior Authorization

In the realm of medical billing, Prior Authorization continues to suffer from a sense of duality as far as general opinion about its usefulness is concerned. Those who tend to side with it consider it essential for lowering healthcare cost and ensuring better patient safety. It is difficult not to agree with this view because the very essence of Prior Authorization constitutes exploring if a prescribed drug or procedure can be replaced by a more generic, and thus cheaper, version. The process also checks for possible harmful drug interactions or side-effects, thereby ensuring a safer outcome for the patient.

In spite of such virtues, Prior Authorization continues to be frowned upon due to its notorious propensity to put a severe strain on a practice’s time and resources. A big reason for this is its dependence on tedious, manual activities such as filling out forms, sending faxes and making phone calls to the insurance company’s front desk. Surveys have shown, time and again, how heavy volumes of Prior Authorization have led to staff burnouts, slackened billing and, on a more serious note, actual patient care getting compromised due to staff shortage (because medical personnel are often brought in to work with the actual billing staff in order to effectively manage the Prior Auth burden).

An Effective Way to End The Fright

It is not hard to see why millions of healthcare personnel consider Prior Authorization such a terrifying entity. But call it a necessary evil or anything else, it is not possible to shrug it off completely. The good news is, there are ways to end the fright and get even with Prior Authorization. Of these, one of the most practical is outsourcing the process to dedicated, third-party specialists.

Strategic offloading of the Prior Authorization burden to billing experts can let providers experience better efficiency in handling PA tasks, save time as well as thousands of dollars in operational cost. Professional intervention helps bring down denial rates, increase approvals and get more PA requests completed in a day than before. All this is made possible because specialized billing agencies employ highly streamlined processes, stringent quality checks and a host of pertinent skills to get the job done faster and more accurately.