How to Ensure a More Efficient Prior Authorization Workflow


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Understanding the demands of Prior Authorization

One of the main reasons why Prior Authorization continues to put a frown on so many providers’ faces is something that is intrinsically rooted in the process itself. It is a process that is still heavily dependent on antiquated practices involving copious amounts of paperwork, faxing and making lengthy telephone calls. Naturally, this causes providers to lose large amounts of time and man-hours to complete even a typical volume of such requests in a day.

This is but the tip of the problem. The real difficulty lies in finding competent and skilled personnel to handle prior authorization requests efficiently, a proposition that has rarely been more difficult that during these times of an acute scarcity of skilled labor in the market. Engaging regular medical staff members, like nurses or others, to handle the extra burden of prior authorizations requests, as may arise from time to time, cannot be a sustainable solution. It can lead to undesirable compromises in the quality of actual patient care.

The road to better efficiency

Faced with problems such as those given above, many providers are outsourcing their prior authorization tasks to external specialists who are getting the job done not only more efficiently, but also at a much lower cost. Strategic outsourcing of carefully selected business processes, especially those pertaining to billing and collections, to specialized experts can produce some truly remarkable results for any healthcare business. Let’s take a closer look.

Effective and efficient handling of prior authorization requires a deep understanding of the process and a close familiarity with various payer norms and regulations. These get automatically ensured when a provider employs experienced, professional assistance, and the results start getting seen from the very first day of the association. With their specialized knowhow, full knowledge of payer norms, and highly streamlined methods of operation, these third-party billing agencies can make wonders in taking your prior authorization to the next level of excellence.


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