Prior authorization is required for advanced outpatient imaging procedures:
- CT scans
- MRIs
- MRAs
- PET scans
- Nuclear medicine studies, including nuclear cardiology
The main focus of a well-managed imaging center’s billing operation is to submit claims for services punctually and in the proper, required format, and receive reimbursement as fast as possible. Performing these services without first obtaining the payer’s authorization will create a denial of payment when the claim for services is submitted. The authorization process begins with information related to patient eligibility – obtaining and verifying correct information about the patient’s insurance plan.
Sunknowledge Services Inc: Action plan in prior authorization for Imaging Centers
Gathering of vital information from patient, provider as well as order information- Check the patient’s eligibility
- Communicate and validate prior auth request with the payers
- Initiate PA requests as per the payer protocols
- Follow up with payer for checking the auth status
- Follow up with ordering physician for the additional documents as requested by the payer
- Provide the additional information as requested by the payer
- Update the auth outcome in the PM/billing system
Our unbeatable advantages
- Guaranteed reduction of billing costs by 70%
- Fast & efficient service with 99.99% accuracy
- Serving over 100 healthcare clients
- Boost average number of approvals by 1.5-2X
- 7 yrs payer side experience in claim adjudication
Looking to know more on how we cater our functional best practices in prior authorization for imaging centers! Our experts are ready to share with you, our complete action plan that will eliminate your practice management worries!