Did you know that physicians and staff spend an average of 14 hours a week on prior Authorization? It may be shocking to read it but that’s what is likely happening in your practice as well! We know you’d rather spend your time seeing patients but jumping through insurance hoops to get procedures approved takes up nearly 2 business days (according to AMA) What if you could outsource your Prior Authorization Services? It turns out there are real benefits to having an experienced team handle authorizations for you.
The Challenges of In-house Prior Authorization Services
Overwhelming Workload – As a medical provider, you and your team are supposed to focus on patient care. We understand that you’re no stranger to the mountains of administrative tasks that come with the territory. But Handling prior authorizations in-house is particularly daunting. Between reviewing patient charts, scheduling appointments, and going back and forth with insurance companies – it’s a full-time job in itself. The time prior authorization services take up can quickly become overwhelming for your staff. Falling behind means treatment delays for your patients and reimbursement delays for your practice. Not an ideal situation.
Strict Compliance Requirements – Navigating the complex web of insurance rules, regulations, and requirements is enough to give anyone a headache. One missed detail or lapse in following the proper procedures could mean a denied claim – and all that effort for nothing. Keeping up with the ever-changing compliance landscape while juggling your other responsibilities is a major challenge. An inadvertent oversight could end up costing you big time.
Pulling Staff Away from Patient Care – Every practice’s primary focus is top-notch patient care but working on prior authorization will divert valuable time and focus from patient care. Valuable clinical staff getting bogged down in administrative drudgery is an inefficient use of resources. Their expertise is better utilized in caring for your patients directly.
The process of prior authorization services is demanding for the in-house teams to say the least. Trying to manage it all on top of your regular clinical workload is a recipe for burnout, delays, and costly mistakes. Perhaps it’s time to explore a better solution?
How Outsourced Prior Authorization Services Can Help?
Save Time and Headaches – You know that tedious prior authorization process all too well – hours on the phone, battling insurance companies for approvals. It’s a massive time drain that pulls your staff away from more important tasks. But what if you could wave a magic wand and make all those headaches disappear? That’s exactly what outsourcing prior authorization services can do for your medical practice.
Expert Team on Your Side – When you partner with a specialized prior auth company, you get an entire expert team dedicated to handling approvals. No more having overworked staff juggling it alongside patient care. These prior auth pros know all the tricks and loopholes to maximize approvals. And they doggedly follow up until the green light comes through.
Boost Revenue and Efficiency – A significant chunk, between 20% and 34%, of healthcare expenditures goes towards administrative costs, including those associated with prior authorizations. By removing prior auth from your plate, you instantly free up clinical staff to focus on higher priorities like patient care and coding. That boosts efficiency across your whole operation. Plus, higher approval rates mean your claims get paid faster and more consistently. That’s a direct revenue boost that helps your bottom line.
Data Insights to Optimize – The best prior authorization services partners also provide deep data insights you can use to streamline operations. You get visibility into approval rates, denials, and more. Spot inefficiencies and make smart adjustments for continuous improvement.
So if prior auth feels like running on a hamster wheel, it’s time to get off. Hand it over to the experts and watch your practice thrive.
Key Benefits of Outsourcing Your Prior Authorization Services
Save Time & Effort – One of the biggest advantages of outsourcing prior authorization services is the immense time and effort it saves your practice. The tedious process of gathering clinical documentation, filling out forms, and following up with payers can consume hours that could be better spent on patient care. By handing off this administrative burden, you free up your staff to focus on more productive tasks. No more wrestling with convoluted payer portals or long hold times – the outsourced team handles it all efficiently.
Increase Revenue – Denials from lack of prior authorization can severely impact your revenue cycle. Having an experienced team ensuring authorizations are obtained properly means fewer rejected claims and faster reimbursement. Their specialized knowledge also helps maximize approval chances the first time. With higher clean claim rates and speedy payments, your bottom line gets a welcome boost.
Consistent Compliance – Keeping up with changing payer rules, policies, and medical necessity criteria across multiple insurance plans is a compliance nightmare. Outsourcing Prior Authorization services make it easy as the experts will stay current on all the latest requirements. You can rest assured authorizations are being secured compliantly while avoiding costly penalties and audits. Their robust processes and quality checks provide an added layer of risk protection.
Scalable Support – As your practice grows, so does your prior authorization workload. Outsourcing gives you a flexible way to scale support up or down as volumes fluctuate, without having to hire and train additional staff. The service seamlessly absorbs surges during busy periods, while only paying for what you need. You gain valuable bandwidth to accommodate more patients and revenues.
By leveraging an outsourced prior authorization team’s specialized expertise and capacity, you can reallocate resources, accelerate cash flow, and mitigate risks for your medical practice. The operational efficiencies gained allow you to concentrate on delivering excellent patient care.