Do you know what healthcare providers struggle with most? It is creating an accurate billing process along with the proper prior authorization service. But as the healthcare staff performs almost all the healthcare operations, that’s why they can’t invest in patient care. So, what is the solution to this burning problem? That’s where you can take the help of outsourced prior authorization services who make sure no claim denial occurs. These experts stay updated with the current regulations and also, they are highly cost-effective compared to the in-house experts.
The administrative burden of prior authorization has enormously increased over the years, which leads to higher overheads. There are several financial impacts of PA which include increased cost. Moreover, denied prior authorization during the adjudication process leads to revenue loss for the healthcare providers. Even worse, it may impact the patient care if they know their insurance won’t cover it. Moreover, the PA process can also result in delayed cash flow, which can cause major headaches for the large and small providers. But the issue is as there are so many companies, how can you choose the right expert for your clinic? Let’s dive into the answer then.
Table of Contents
Benefits of Choosing the Right Prior Authorization Services
There are several benefits of prior authorization, starting from staying current with the latest regulation to using the right technology. So, all the benefits are described below:
Staying Current with the Latest Regulations
The healthcare regulations are constantly changing because of the introduction of new diseases. However, if the healthcare staff have to stay updated with the latest regulations, then they may not get the time to improve patient care. So, here you can get the help of outsourced companies who know all the complex CPT, ICD and HCPCS codes. Apart from that, they also know all the complex nuances of the HIPAA law to protect patient data. So, choose those experts who stay updated with all the latest regulations.
Taking Care of the Prior Authorization
Prior authorization is a very hectic process, and it also takes a lot of time. Here, first you need to verify patient insurance eligibility, collect important patient documents and submit prior authorization request. Here, also if the healthcare staff keep on getting updated with all the latest prior authorization procedures, then they may not get the time to improve patient care. Here, the outsourced prior authorization services know all the intricate details of the prior authorization procedures. That is also one of the major reasons to hire outsourced experts.
Cost-effectiveness
The in-house teams come with a high cost because you need to train them and also buy expensive office space for them. However, on the other hand, the outsourced experts get constantly trained with all the latest healthcare changes so that no claim denial occurs. Moreover, the outsourced experts also provide them with the required office space, which also reduces significant costs for the healthcare providers. Hence, the clinics can invest the remaining cost in patient care which will boost patient satisfaction levels.
Technological Growth
There are very few RCM companies who know how to use the right technologies to fasten the claim submission process which is beneficial for prior authorization procedure. However, it has been observed that the healthcare staff struggle to use the right technology as they don’t have the expertise in this matter. So, here you can also get the help of prior authorization services who can significantly grow your clinic’s revenue. They also know how to do electronic prior authorization procedures to submit claims electronically.
The Future of Prior Authorization
The future looks promising as there are so many advancements of prior authorization happening in the US. So, before hiring any expert, check if they help with initiating prior authorization request, ensure the details are collected from the physician’s office, work with both the payer and the provider, follow up with the prior authorization outcome, know whether they need any additional documents or not and finally, update the prior authorization outcome in the clinic’s EHR system. These companies provide pre-authorization solutions which consist of verification and documentation services, hassle-free claim settlements, managing complex coding and follow-up services. These companies don’t have any hidden fees, and they provide their service at a highly competitive rate.
They guarantee full-HIPAA compliance, and the systematic approach ensures rapid approval rate. These services can reduce your operational costs by 80% and they work with 99.9% accuracy. These companies also provide 10% buffer resource and dedicated account managers at no extra cost. They also take care of different prior authorization specialties which include ambulatory surgery, anesthesiology, cardiology, dental billing, durable medical equipment, emergency medicine, family practitioner and many more. So, if you want to streamline your billing process, you may consider outsourcing to prior authorization services in that matter.
