Ensuring a Comprehensive Prior Authorization Journey for Providers

One of the genuine challenges for providers and payers regarding disputes with prior authorization is establishing medical necessity. Payers while determining if the criterion is met look for factors like if the treatment is needed according to latest and research backed evidence.

  • Also, they will be checking that the service doesn’t get duplicated. Finding a top class prior authorization partner is going to be a huge blessing and can actually help in transforming your ROI by working as a genuine operational extension.
  • If you are having lung cancer, there might be a possibility that you are seeing two specialists. The lung provider can order a CT scan for you not realizing that the cancer treatment provider might have undergone one two weeks ago.

Both patients and providers bear the brunt of the medical and prescription delays. Hence, making sure that all your prior authorization demands are looked after by specialists can be a huge blessing for you in the long run.

Realize it with Sunknowledge

Looking for someone that can help you with checking of insurance verification and prior authorization requirements, we are right here for you. Our team will love to share a complete business synergy on what sets us apart in the entire prior authorization scene. We have a team of expert pre cert/ pre authorization experts that can work as your ideal guide at these testing times of employee shortage.

Get to know why we are hailed as one of the best in the entire healthcare services space. We will be glad to hear and know what makes us unique and assists us in generating consistent revenue by working as a consistent operational arm.

We understand your collection worries better than anyone and can help you in working with your payers a lot better. Our team knows how to initiate PA request, working on eligibilities, contacting the physician office, getting all the documents collated and sent to payers, talking to payers on auth outcome, updating the same in the client PM billing system.