- August 11, 2022
- Posted by: Josh Knoll
- Category: Prior Authorization
The Dark Side of Prior Authorization
Even as the debate continues to rage over the need for prior authorization and if it inadvertently hampers the patient care, it remains one of the toughest jobs to handle in the entire medical billing cycle. Essentially a preventive and corrective measure implemented by insurance companies to curb unnecessary overspending in healthcare, prior authorization can easily eat into the back office’s time and take a toll on overall productivity.
The main reason for this is, securing prior auth for a prescribed procedure, supply or medication is not a simple process and definitely, not one that can be completed quickly. It requires extensive documentation that should support every such request, sending multiple faxes and making phone calls and many tedious minutes of waiting before the insurance company gives a verdict. And when you have a good number of prior auth requests to complete in a day, all hell can break loose in your billing department.
Looking for a Solution
It’s no wonder that prior authorization is widely considered to be among the top reasons for employee burnouts, or people simply quitting their jobs, in the billing & collections department. The trouble is, no matter how much healthcare practices may hate it, they cannot afford to ignore it. Revenue and collections depend heavily on getting your prior auths sorted and completed in time. After all, neither you nor your patients will like being denied their due reimbursement by the insurance companies.
A natural consequence of having to handle all the usual hassles of prior authorization is facing the urge to find a solution that can make life easy for all. The solution, in this case, is outsourcing the process to specialized, third party agencies. A skilled and competent billing partner, who is willing to take care of all your preauthorization requirements, can really do wonders to your entire revenue cycle. Not only can such specialized intervention increase overall collections, reduce denials and stabilize the revenue flow, it can also free up your resources to pursue other important tasks in your organization or simply, enjoy a better work-life balance. For any healthcare organization serious about employee welfare and retaining its staff for longer, outsourcing can be a great option to consider.