- February 19, 2021
- Posted by: Thomas Anderson
- Category: Prosthetics Prior Authorization
Experiencing a seamless successful prosthetics prior authorization process requires great skill and experience. As being a complex process, an inexperienced person handling your authorization will only lead to lengthy prior authorization protocols impeding timely patient access to care and harmed patient clinical outcomes.
There are multiple reasons why a prior authorization may be rejected and not reviewed. In fact, the most common reason for authorization rejections includes:
♣ The HCPCS codes is not subjected to the prior authorization
♣ Duplicate prior authorization request
♣ Prior authorization request sent to the incorrect jurisdiction
♣ Delay in authorization submission and many more
However, a complete authorization knowledge along with proper completion of the DME, HME Orthotics, prosthetics prior authorization coversheet and thorough intake process can not only help to minimize most of the authorization rejection but also ensures a faster and seamless prosthetics prior authorization solution.
In fact today Sunknowledge Services Inc is one such RCM organization that helps in closing all the authorization gaps faster and efficiently being one of the leading authorization solution across the US.
Taking care of all your prosthetics prior authorization, our experts assure complete documentation for your authorization process starting from the collection of:
♣ Standard written order
♣ Documentation from the medical record to support medical necessity
♣ Prosthetics record
♣ Prior authorization coversheet indicating quantity and side of prosthetic components
♣ PDAC verification
In fact, starting with prescription from the regulatory physician dated earlier to delivery date a prosthetics prior authorization has few other important requirements like:
♣ Consideration of restrictions based on the time within which the item can be covered if supplied earlier.
♣ Billing of suitable modifiers, e .g. KX, LT / RT, NU etc.
♣ Coverage of gadgets additionally subject to qualifying diagnosis, e.g. orthotic shoes are not secured unless diagnosis states diabetic
♣ Repair, replacement and supplies may be eligible for divided compensation
Taking the complete authorization process responsibility, our experts further help you with 80% operational cost reductions. Maintaining a 99.9% accuracy rate reducing your chances of denial and rejection, our experts ensure the highest collection rate of 97% within the first 30 days from the date of billing itself.
Driving you flow of reimbursement by working as a reliable operational extension, our experts further secures 100% authorization submission on the same day increasing your authorization rate by 1.5 – 2x.
In fact, working as a reliable operational extension for more than 10 years now, we have excellent industry references across the U.S delivering not only tailor made authorization solutions but full cost effective medical billing service destination.