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:

  • Specialist Referrals
  • Surgical, Procedure and Other Service-Based Authorizations
  • Lab and Radiology Orders

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

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 even handle appeals if necessary. 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!

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