Outsourcing Prior Authorization: What You Need to Know

Why outsource Prior Authorization?

In the healthcare sector, prior authorization is one of the most common ‘business processes’ to be outsourced. While many providers are yet to wake up to the rhyme or reason of it, a large number of them are only too happy to outsource their prior authorization tasks to an external agency. But is it an overhyped phenomenon, or is there really any worth in it? Let’s investigate.

Prior authorization has always been considered a time and resource-intensive process. Owing to its heavy dependence on traditional methods involving paperwork, sending faxes, and making telephone calls, prior authorization can take many long minutes to be completed. A recent survey has revealed that on average, a week’s prior auth activities can equate to almost 2 business days.

In view of this, healthcare providers across various specialties are increasingly delegating prior authorization tasks to external third-party billing personnel. This is not only helping them free up their regular staff members so that they are available to attend to actual patient care and other more important aspects of the practice, but also lowering their operational costs and eradicating many of the associated hassles.

Choosing the right partner

Success with outsourcing can be easily ensured with the right partner. There is no dearth of medical billing companies to be found today, offering all manners of support to healthcare providers to ease their billing & collections worries. But they do not have the same levels of expertise, experience or competence. So it is always advisable to choose wisely and pick the best billing company that one can find.

A good place to start is by considering the amount of experience that a billing company has. Being in the medical billing business for a good number of years is, almost always, a sign of being competent and of possessing adequate knowledge and expertise in the field. However, one should also try to find out what the company’s clients, both past and present, are saying about the quality of its services. Client testimonials can provide great insights into the real capabilities of a service provider.

Pecuniary concerns, of course, are an important concern. But before you get taken in by the promise of a low price, be sure to check if there are any hidden fees involved. Be sure to read the fine print before signing the contract. With a little caution, it is not difficult to pick a great billing partner without running into any unpleasant surprises afterward.