- July 18, 2022
- Posted by: Thomas Anderson
- Category: Prior Authorization
Prior Authorization – An Impediment, or a Boon in Disguise?
Opinions are widely divided when it comes to understanding and acknowledging the necessity for prior authorization. Essentially a mandate introduced by insurance payers with a view to keeping health care expenses in control, prior authorization is often considered as an obstacle in delivering timely care. This is mainly because the process involves time that can delay treatment. It is also a process that can cause a lot of headaches for practices by its insistence of being accompanied by tons of paperwork, dozens of phone calls and long hold times.
In a recent survey conducted by AMA (American Medical Association) involving practicing physicians, it was revealed that 91% thought that prior authorization can lead to negative clinical outcomes while 82% stating that it can lead to patients abandoning their course of treatment. 34% of all surveyed said that prior authorization has led to an adverse outcome for a patient. To make matters worse, physicians reported that they completed an average of 41 prior authorizations per physician per week, a weekly workload for a single doctor that was equivalent to nearly two business days of physician and staff time.
Adopting a Better Modus Operandi
These are serious stats that compel health care providers to review and reappraise their prior auth methods. Conducting medical billing processes the usual way, with regular staff members and back-office personnel, can prove to be a costly and time-consuming proposition. For small or medium practices, maintaining an in-house team of billers, coders and collection experts can eat into overall profitability and actually hurt the bottom line.
This is the reason why a growing number of health care practices across the U.S. are outsourcing their billing tasks to dedicated and specialized experts in the field. When it comes to resource and time-intensive processes like obtaining prior authorization, an area that can benefit immensely from specialized intervention, having a dedicated and skilled team of billing and collection experts working for you can make a big difference. Offshore outsourcing also allows providers to get all their prior auth requests completed at a fraction of the usual cost, resulting in substantial savings. Offloading the process to an external agent also allows them to free up their resources that were hitherto engaged in the tedious process and find more time to pursue other critical activities such as actual patient care or expanding the current practice.