What if we told you that obtaining preauthorization no longer needs to be a time consuming and troublesome process? While many physicians are strongly pushing for complete elimination of preauthorizations, this scenario is unlikely. But fortunately there are a few steps that physicians can take in order to speed up this process and make prior authorizations much less costly and vexatious.
Step #1: Outsource Your Prior Authorizations
Taking into consideration how much time your staff likely spends completing prior authorizations, it doesn’t make sense to put someone who doesn’t have experience in charge of having them completed. Not only will this be much more time consuming, but it can also lead to unnecessary mistakes. Instead, hire a company whose main focus is prior authorizations and has the expertise in this area. Not only does outsourcing this process save your medical center money in the long run, but because prior authorization specialists are continuously trained on new policies and guidelines, it will prevent you from the burden of preauth training. It also alleviates the headache that typically comes with having stacks of paperwork to fill out on top of a long day of work.
Step #2: Make Sure All of Your Ducks Are in a Row
When submitting your prior authorizations, ensure that you are providing a complete request that is backed up by well-documented data. Taking shortcuts puts you at a higher risk of denial, after which you will need to gather and write up the documentation the way that it should have been completed and sub the first time around. In order to ensure that the prior authorization process is as quick and efficient as possible, be sure you have the following patient information for submission:
- Patient name (as it appears on the health ID card)
- Health ID card number
- Birth date
- Gender
- Address
- Phone Number
- Email (if available)
- Relevant information, including:
- Provider notes
- Test results (labs, X-ray reports, etc.)
- Patient history
- Physical findings
- All office visits related to the condition
- Requested tests along with CPT codes and units (if applicable)
Along with this patient information, you will also want to be sure to include both the ordering and performing provider’s information. When you submit this through a web portal with a preauth provider such as AuthNet, you will increase the likelihood of receiving quicker, real-time information.
Step #3: Embrace Technology
When you outsource your prior authorizations, you also gain access to a comprehensive, easy-to-use portal that makes submitting prior authorizations easier than ever. Plus, you get real-time feedback on the status of each request. Not only is this a much more eco-friendly option than using paper, but it also greatly speeds up the process.
