AuthNet wants to keep our clients updated on everything that is going on in the world of prior authorization and precertification. As of June 5, 2019, there is talk of a bill on pre-authorization services going to Congress. The bill is expected to be introduced to Congress within the next couple of days. In our blog today, we will take a look at what this bill involves and why it matters to pre-authorization services.

What Is The Bill?

The name of the bill is the “Improving Seniors’ Timely Access to Care Act of 2019.” This bill is specifically addressing issues with pre-authorization services for Medicare Advantage plans. It includes protections for beneficiaries and a strategy for making real-time decisions in order to avoid the lengthy waiting periods associated with pre-authorization. In short, the bill is attempting to simplify the process for pre-authorization for Medicare Advantage plans.

This attempt to streamline the pre-authorization process for Medicare Advantage would involve several elements. The bill also requires stakeholders to give Congress recommendations on ways to further streamline the pre-authorization process. It will set standards for the pre-authorization process and, ultimately, make Medicare Advantage plans simpler.

This bill will be introduced by a bipartisan group in Congress. Cosponsors of the bipartisan bill include Rep. Roger Marshall, MD (R-Kan.), Rep. Mike Kelly (R-Pa.), Rep. Ami Bera, MD (D-Calif.), and Rep. Suzan DelBene (D-Wash.).

The Costs Of Pre-Authorization

While it’s important to stay informed on any updates on precertification and pre-authorization, we also want to explore this bill because it sheds light on a broader issue for pre-authorization services. There have been several moves made in Congress over the past few months that have been in the service of streamlining pre-authorization. The “Improving Seniors’ Timely Access to Care Act of 2019” is not unique in this regard. Why is that?

In short, the reason why there have been moves to make this process simpler is because pre-authorization can be complex, expensive, and can have a direct negative impact on the functioning of medical offices. As we have discussed before, prior-authorizations can cost an office tens of thousands of dollars per year. It also slows everything down, which in turn negatively affects overall patient experience. This, too, can reverberate through the office, creating worse attitudes for your employees. Ultimately, the costs of all this can be incalculable.

Pre-Authorization Services

The fact that there have been moves to streamline the pre-authorization process goes to show how difficult and costly the entire process can be. The amount of money you will save and the increases in patient and employee experiences are truly priceless. AuthNet can take over all the costly pain that goes into pre-authorization services. Let these bills act as a demonstration of how much pain can be avoided by outsourcing your pre-authorization services.

AuthNet will continue to keep you updated on any news about pre-authorization. Be sure to check out our blog to stay informed. In the meantime, find out how AuthNet can help you today!