Why You Should Consider Remote Authorizations Coordinators
Clinics are spending up to 11 hours per week on authorizations per provider per week. Connect Dr Solutions can eliminate 90-95% of authorizations for your practice…
Most patients are waiting for prior authorizations and that wait is negatively impacting their care. That’s why it’s critical that you get patient prior authorizations approved as quickly as possible — so you can get paid and your patients can get the treatment they need.
The good news is that you can reduce your prior authorization burden when you organize your workflow with a focus on forming relationships, improving accuracy, and remaining diligent. Here are 8 tips to help you get those prior authorizations approved faster.
Push Prior Authorization to Avoid Treatment Abandonment
Requesting prior authorization for a patient service is more than a formality — it’s a process that deeply affects patient health. A 2017 AMA Prior Authorization Physician Survey reported that, in a one-week time span, 64% of physicians waited at least one business day for a prior authorization decision from a patient’s health plan, and 30% reported they waited at least three business days. Furthermore, 92% of physicians reported that the process does indeed delay access to medical care, 78% reported that these delays often lead to treatment abandonment, and 92% report that the process can have a negative impact on patient outcomes.
Maximize Your Practice Management (PMS) and Electronic Medical Records (EMR) Systems
You are likely paying a lot of money for your PMS/EMR systems, so maximize their efficiency! Work with your PMS/EMR vendors to develop the management reports that you need to monitor and perfect your prior authorization process efficiency. Use it to create workflows that don’t allow for a margin of error. Your management reports should demonstrate when authorizations are required and when they are obtained. Also, take advantage of other resources supplied by your PMS/EMR vendor, such as user groups and conferences.
User groups are a great way to connect with other users and administrators who might have different solutions that you haven’t tried. Attending conferences offers a great opportunity to let your vendors know your needs. For example, if they aren’t offering the reports you need to get your prior authorizations covered, let them know because you’re probably not the only one.
Educate Physicians on Documentation Requirements to Support Approval
It’s important that providers are educated in the patient prior authorization process. They should know what insurance the patient has and who to contact if the procedure changes midstream. But they should also be educated on the entire process because their documentation is so important to the process.
Make sure they understand conservative treatment because insurance companies will generally want to know that conservative treatment failed before approving a more invasive procedure. Let the physicians know about your challenges and give them feedback. If they don’t want to listen, collect and deliver the lost revenue numbers to them. Most often numbers speak louder than words!