How much time do you spend chasing pre-approvals for nuclear imaging or other cardiology procedures at your practice?
Getting pre-authorizations can help make sure your patient’s insurance covers their procedure, but it takes up so much of your time! It’s super frustrating and slows everything down. Doctors and staff often feel stuck because the long process cuts into their productivity and delays patient care.
First, you must understand prior authorization so that you can take measurable steps to handle it well.
What is pre-authorization?
Let’s hear how the American Medical Association defines prior authorization.
You must obtain advance approval from a patient’s insurance company before administering certain procedures, services, devices, and medications and this exact process is called prior authorization. Always remember that missing prior authorization can lead your practice to face negative impacts like poor cash flow, revenue leakage and unexpected payment surprises for your patients. In fact, prior authorization can cause a lot of issues starting from:
- Delayed access for your patients to receive timely care, services, and therapies
- Increased overhead costs for your practice as you need to hire adequate staff members to manage the prior authorization process
- Eats up a significant amount of time from your patient care
- Inefficiency in your practice workflow
You have probably already realized that the rules for fixing prior authorization are getting tighter with time, especially after the change of the federal administration. Administration always aims to keep costs down for the patients, especially with the advanced and expensive treatment options. You should always efficiently deal with prior authorization services as long as the fee-for-service system remains active.
Do you know that pre-authorization takes up a ton of your team’s time? The AMA says it uses about 1 hour of your time, 13.1 hours of nurse time, and 6.3 hours of clerical time every week. That adds up to 853 hours a year—costing you $82,975 in labor for every full-time physician!
Fortunately, you can streamline a smooth prior authorization solution by leveraging an electronic preauthorization service. For that you must know how an ePA system works.
Understanding all about electronic prior authorization:
You might use electronic pre-authorization systems in your practice, and they can help a little. But here’s the problem: health plans have their own forms, and it’s hard for the software to handle all the different rules. So, you still end up doing some things manually. That’s why electronic pre-authorizations don’t always save you much time—you’re stuck using a mix of both systems!
The harsh reality is that most healthcare practices lack adequate staff members or budget for purchasing a costly ePA tool; if you are also one of them, outsourcing prior authorization can be a great help for you.
With all these confusions and difficulties today one of the most convenient and cost-effective solutions to fix prior authorization is to outsource pre-authorization solutions.
Outsource prior authorization to get away from the hassle:
When you outsource your pre-authorizations, you let someone else handle the hard stuff for you. A third-party company steps in to work between you and the payer. They take patient info from your practice and get the pre-approvals you need for certain procedures, services, or devices. It’s like having a helper to take care of it all for you!
You get a big advantage when you use an outsourced pre-authorization service. They’ve got a super-organized system that helps cut down on mistakes with patient info. Since they focus only on this kind of work, they know exactly what to do. Unlike you and your team—who are juggling this along with everything else—they’re pros at getting it done right!
You deserve more time to focus on your patients, not paperwork. Prior authorization outsourcing takes the hassle off your plate, letting experts handle the process smoothly and efficiently. You’ll save time, cut costs, and boost your workflow. Say goodbye to delays and hello to patient care that flows like clockwork!
