Insurance Pre-Authorization Services
Serving physicians and clinics for a better workflow
As a physician, you have specialized expertise in regard to what you do every day. Well, so do we! The AuthNet team is comprised of experienced, trained insurance pre-certification professionals. We use our expertise to make the insurance prior-authorization process as seamless as possible so you can focus on those things that you specialize in. Connect with us today to request a demo and see how our process works.
You Could Be Wasting Thousands Of Dollars Without A Pre-Cert Service! Here’s Why:
Handling insurance pre-certs yourself can create a large burden of time and effort that detracts from the time you have to care for your patients.
• When submission, tracking, and follow-up time is counted — plus basic labor costs — physician-submitted precertification request can cost $35 to $100 each.
• In 2017, electronic pre-cert submissions accounted for only 8 percent of all requests. The remainder were all manually submitted via fax or phone call.
• Physician-submitted precertification requests accounted for an average of 853 hours of staff time wasted per year. That’s over 35 days straight.
• Insurance prior authorizations are responsible for 92 percent of care delays, including treatment abandonment.
• When time is factored in, the median cost for a full-time physician to handle their own precertification requests is $47,707 per year.
Pre-certifications. Prior authorizations. Preauthorizations. Lots of different names for a singular process that can have such significant impacts on a physician practice. Doctors and their staff are feeling the administrative crunch of prior auths more than ever, as coding complexities increase and payers become more detailed about what’s required to obtain approvals for various procedures and referrals.
According to the AMA, nearly half of physicians report that prior auth requests “often or always” hold up care, affecting not only the stress levels of the staff working the requests, but patients who are awaiting much needed care.
AuthNet provides immediate relief, freeing primary care and specialty physicians and their staff to return their attention to patient care and other important administrative responsibilities. Whether you’re scheduling a procedure 60-days out or seeking a stat turnaround time, 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)
At a health system with a support staff of hundreds, there is typically a dedicated team to help with all the aspects of medical billing and coding. If they struggle to get insurance prior authorizations in a timely manner, it stands to reason that individual clinics and physician practices would have an even harder time getting the authorizations patients need. Without a dedicated precert team, or with only a small one, your staff may be stretched too thin to provide the support your practice needs to operate well.
A single missed insurance precertification can initiate a chain of events that will impact your practice as a whole. First, the lack of insurance authorization likely means the patient will have to wait around or return at a later date. In either case, scheduling is thrown off, the patient is likely disgruntled, other patients may also have to wait longer, and billing is affected.
Keeping Up With Precert Demands
The hassle of insurance preauthorization issues doesn’t have to be the norm. Here at AuthNet, we provide a combination of precertification specialists and secure software to help you minimize the pre-certification misses. Input a patient’s details and we’ll handle the legwork necessary for getting an insurance authorization or pre-authorization.
Since we have a dedicated staff who focus on the prior-authorization process, we have the focus and the skills to make sure each request is diligently tracked from request to completion. This means fewer patients showing up for appointments without the necessary prior-authorization, fewer scheduling changes or delays, and fewer patients who leave unhappy with the care they received. Plus, with insurance precertification needs being handled before a patient arrives, billing is less likely to be delayed and your practice can run a bit more smoothly.
How We Do It
The prior-authorization process through AuthNet is pretty straightforward. Start by entering a patient’s information into our secure, HIPAA-compliant portal. We’ll need standard demographic information, diagnosis, and CPT codes to get going. This will generate a ticket to tell our team to get going. We’ll initiate the precertification process with the patient’s insurance provider, follow up on any additional information needed, and collect all the necessary options and details for appeal in the event of a denial. We’ll keep information updated in the portal so you can get all the information we have about each patient’s precerts.
Experience the ease for yourself. Connect with the AuthNet team today to learn more and start with a demo!