- April 14, 2020
- Posted by: Thomas Anderson
- Category: Prior Authorization
In 2019, almost 22 million people have enrolled to Medicare Advantage Plans, similar to 2017 and 2018. Between 2018 and 2019, total enrollment of Medicare Advantage grew by 1.6 million beneficiaries, nearly the same growth rate as the prior year. The CBO, Congressional Budget Office projects the share of beneficiaries to rise by 47% by 2029.
Unlike Traditional Medicare which does not require prior auth for a vast majority of services, Medicare Advantage plans can require enrollees to get the approval from the plan prior to receiving the service. If approval is not granted, the plan generally does not cover the cost of the service. Prior authorization requirements surely create hurdles for the beneficiaries as well as their beneficiaries, limiting access to both necessary and unnecessary care.
♦ 80% of the Medicare enrollees are in plans that require prior authorization for at least one Medicare covered service.
♦ 70% of enrollees are in plans that need prior authorization for DME, Part B drugs, skilled nursing facility stays, and in-patient hospital stays
♦ 60% of enrollees are in plans that need prior authorization for AMBULANCE, Home health procedures and lab tests
♦ More than half of enrollees are in plans that need prior authorization for mental health services
It is pretty evident, that as a healthcare provider, you will have to ensure better chances of securing reimbursements, better patient experience with a streamlined prior authorization approach. Finding a reliable partner that can take care of all your prior authorization requirements will be the best possible step forward!
Sunknowledge Services Inc: A Complete Prior Authorization Destination
Capability of delivering stand out assistance by performing task specific activities in eligibility verification, prior auth, doctor’s office follow up , order entry, Sunknowledge Services Inc has the perfect answer for your front end revenue cycle management needs.
As a reliable operational arm, our team is proficient across all major billing systems like Brightree, Kareo, OPIE, Fastrack, CPR+ HME, TEAMDME and many more, offer seamless transition. Also, we are capable with any client proprietary platform and deliver according to your protocols.
We offer you better visibility for the 2021 DMEPOS bid as we allow you to bid lower.
Sunknowledge Services Inc offers you the best possibility of increasing your collections by 80% within the first 30 days by getting your prior authorization approved by us with unparalleled accuracy and faster turn around time!
Why choose us as your reliable prior authorization destination in DME
♦ Instant reduction of costs by 80%
♦ FREE medical billing software, EMR & setup
♦ Real-time eligibility checks & fast authorization
♦ 100% prior authorization submission on the same day
♦ Increase current rate of completed requests by 1.5 – 2X
♦ 100% HIPAA-HITECH compliance
♦ Rapid claim status analysis in denial management
♦ Turnaround time less than 48 hours max.
♦ Low service fees with no hidden cost
♦ No binding contracts
♦ Over 100’s of client references across the country
♦ Real-time audits and custom reporting
♦ Highest productivity metrics in the whole RCM world
♦ Billing experience for all DME products
Let us share with you, our best practices, capabilities in prior authorization for DME over a “no commitment call”. Sunknowledge Services Inc can meet or beat any price and offers unparalleled operational transparency and great productivity metrics.
Talk to Ronnie Hastings, an industry expert with extensive understanding of modern dynamics in the healthcare services space. As a revenue cycle management specialist, Ronnie has driven growth initiatives for some of the biggest names in the DME/HME/O&P space.
Also, he has driven cash flow efforts for leading hospitals, nursing homes, radiology centers, imaging & dermatology practices and many more. Leverage the Sunknowledge advantage for a streamlined prior authorization experience.