Today prior authorization has become a more complicated process that requires special attention. No healthcare provider, diagnostic provider, or patients want to wait long to experience a complex process.
Unlike other pre-service activities, such as eligibility and benefits inquiries, prior authorizations require a high level of coordination between physicians, diagnostic providers, payers, and, most importantly, authorization experts.
Involving fax, phone calls, and multiple portals almost take up 20 hours of in-house staff and physician's time per week. Healthcare providers often lack resources to focus on the authorization process for ancillary services such as lab tests, imaging studies, remote patient monitoring, and orthotics & prosthetics.
With the average salary of $18.96 per hour for a Prior Authorization Specialist and the above problems along with the disadvantages of the patients, leave no other scope for the healthcare providers apart from outsourcing.
PriorAuth Online, powered by Sunknowledge Services Inc with its decade of experience and expertise, has developed a web-based authorization platform that eliminates the prior authorization gap faster and efficiently. Being a prior authorization platform for all HME, DME, orthotics, and prosthetics, etc., PriorAuth Online experts excel in significantly reducing the time spent per prior authorization case and also expedite time for decision making.
Analyzing the missing data that result in a rejection or denial in the orthotics and prosthetics' prior authorization, PriorAuth Online experts take the extra initiative in doctor office follow-up and patient calling for relevant documents needed for the process.
By understanding the patients, healthcare providers, and industry mandate, PriorAuth Online expert also provide robust reporting according to all the clients' protocol.
Streamlining the orthotics and prosthetics' prior authorization and other specialties' authorization workflows, our experts not only prevent denials and ensure patients receive the essential diagnostic information but also reduce the administrative time. With a 99.9% accuracy rate and highest productivity metrics, PriorAuth Online charge as low as $7 per hour, which is half of what authorization experts get.
Knowing the workflow of prior authorizations that starts at the physician's office, PriorAuth Online complete authorization is divided into:
Authorization initiation- information is obtained in this first stage, which is necessary for the treatment process. This then is followed by authorization initiation. The information which is collected includes patient name, DOB, ordering provider's name, NPI, Tax ID, address, phone no along with insurance information. We also ensure a proper check on the diagnosis code, units for each service code, if ordering physician is PECOS certifies or not
Requesting authorization - this is the most critical part where documentation is been completed accurately collected through fax, call etc. after which verified and validated the documentation along with the authorization request is done. In this process, it is crucial to maintain constant oversight over all prior authorization requests that are outstanding
Continuous follow-up is made - our second last steps ensure investigating to resolve whether the patient is eligible based on payer requirements for prior authorization. Once this is done, prior authorization is initiating through outbound calls, portal, etc. as per payers' protocols/guidelines. Here waiting on the approval or denial of their request for ongoing authorization happen
Updating the authorization process- This concludes with providing additional documents/ data if requested by the payer. This ends up updating all the prior authorization results in the billing system.
Cutting down the operational cost by 80% with the highest first-pass collection rate, PriorAuth Online today has more than 100s of satisfied clients and excellent client references. PriorAuth Online is the one-stop orthotics and prosthetics destination offering seamless operation and enhancing revenue generation for many leading names in the industry. To know more about PriorAuth Online and how the PriorAuth Online expert can help you with your orthotics and prosthetics prior authorization process, get in touch with us.
Content Strategist by profession. Expertise in staffing, recruitment, human resource, and Tax