Health System & Hospital Authorizations

Prior Authorization Services On A Grand Scale

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The Professional Pre-Cert Help You Need

The insurance pre-certification process can come with a high cost — when not done effectively, that is. AuthNet provides efficient and HIPAA-compliant pre-cert services to help save time and money while minimizing errors. With scalable services, we can serve any hospital or health system’s needs. Demo today to experience the ease.

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How Your Insurance Pre-Certification Process Could Be Costing You:

  • The average physician requests 29 medical approvals per week. In a health system, that’s thousands of pre-certs to track and process.

  • A whopping 92 percent of care delays (including treatment abandonment) happen because of the prior-authorization process.

  • As of 2017, only 8 percent of physicians used electronic pre-cert submission options.

  • Labor costs range from $35 to $100 per approval — and that cost rises when requests are not submitted electronically.

  • Insurance prior-authorizations account for $31 billion in annual expenses across the industry.

  • The median cost for pre-certs is $47,707 per full-time physician, including time spent submitting requests, following up, appealing, and other time-inclusive factors (i.e. appointment rescheduling).

  • Healthcare providers could save more than $7.5 billion a year if electronic pre-cert authorizations were fully adopted.

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Hospitals & Health Systems

As coding complexities and payer requirements for obtaining pre-certification approvals increase, more and more hospitals and health systems find their revenue cycle performance and overhead management locked up in the PA process. The task remains heavily manual and often disjointed between clinics and hospital staff, gobbling up time from billing staff, impeding patient access and slowing payment cycles.

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With AuthNet, both community and enterprise health systems have a flexible, responsive partner who can streamline PA workflows, speed decision turnaround times, simplify the patient’s care delivery process.

Available as both a full outsource or supplemental service to your existing staff, AuthNet has you covered:

  • Inpatient and Outpatient Surgeries and Procedures
  • Referral and E&M-Based Submissions
  • Therapy, Rehab and other Service-Based Submissions
  • Injections, Infusions & Specialty Medication
  • Standard, Genetic and Molecular Labs
  • Radiology, Diagnostics, Ultrasound Scans and More
  • Durable Medical Equipment (DME)

Ditch the prior auth headache. Contact AuthNet to request a FREE ROI ANALYSIS and to learn more about our services.

Even with a staff of hundreds, insurance coding and precertification can be an incredibly complex system to navigate — definitely more so when your insurance precertification team has to handle so many different departments and specialties, not just the array of different health insurance providers. Hospital and health system billing and coding departments are often understaffed and overworked, making it even harder for your staff to get the ongoing training they need to keep the insurance precertification needs running smoothly on top of the myriad other tasks they need to take on. It’s time to make the process easier and help your health system run more smoothly.

How It Works

AuthNet provides a flexible, easy to use insurance authorization service to fill in the gaps of your current process. Between our software, a secure portal, and our knowledgeable staff, we can handle just about every step of the precertification process after you collect the patient’s information. That’s right, it really can be that easy. Upload a patient’s information and diagnosis, request lab orders, inpatient admission, surgical procedures, pain blocks, or anything else that may need an insurance authorization or preauthorization. Then simply submit a ticket to initiate the precert process with the AuthNet team.

From there, we’ll take over. If more information is needed, we’ll do what we can to collect those details or let you know the insurance provider needs to connect with a member of your medical team. If the authorization is granted, we’ll enter the data accordingly and transmit it back to you via the secure portal. If, on the other hand, an authorization is not granted, we’ll provide the necessary details and options for follow-up or appeals. We’ll update files appropriately and get that information back to you in a timely manner. That’s all it takes!

How We Help

Our goal is to provide the tools and knowledgeable staff to help streamline the insurance prior authorization process. By providing a dedicated team to handle medical prior authorization needs, we can help you streamline your billing process. And, better still, our staff isn’t stretched between several different aspects of the healthcare billing process, so we can provide dedicated attention to each case. This means fewer problems with things falling through the cracks and, ultimately, a better patient experience.

Want to learn more about the benefits and how our insurance prior authorization process works? Connect with the AuthNet team today to get the details and try a demo!

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