How Your Prior Authorization Efforts Can Benefit From Systematic Intervention

Tackling The Demands of Prior Authorization

Ask any healthcare provider about which aspect of their billing process tends to appear the most challenging, and the answer you are likely to get is prior authorization. In spite of a host of recent developments to simplify and quicken the process, prior authorization remains one of the most time-consuming and taxing processes in the entire chain of tasks that together comprise a successful billing cycle. The process itself is mostly constituted of gathering documents, sending faxes and making lengthy telephone calls to the insurance office. And in spite of one’s best intentions, the slightest error or slip can lead to a summary rejection of the request.

It is clearly evident that the demands of prior authorization (also referred to as precertification or pre-authorization in many cases) are many and can keep any practice on its toes. Healthcare practices, according to a recent survey, typically spend almost 2 days’ worth of time in pursuing prior authorization tasks. This not only eats into the time of a practice which could have otherwise been spent in actual patient care, but also puts an enormous amount of strain on the personnel engaged for the purpose. As a result, a drop in efficiency is often noticed, coupled with frequent burnouts.

The Benefits of Systematic Intervention

To counter the ill-effects of prior authorization and in order to handle its demands more efficiently, a large number of healthcare providers often seek external assistance. Such intervention can be introduced step by step, without effecting a drastic change in the billing and collections department. Many providers can be seen today engaging professional assistance from external quarters to take care of any extra prior auth burden. They retain their regular in-house staff, knowing their limitations and allowing them to handle as much prior authorization requests as they are comfortably able to handle. The extra amount is passed on to the third-party agency which deftly takes care of it in an efficient and cost-effective manner.

It is worth remembering that a skilled and competent billing partner, who is willing to take care of all your pre authorization 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.