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Prior Authorization Cure With A Decision Automation Process


Patients suffer an extreme late in medical prescriptions and procedures, overdue accounts, problems with paperwork is a big challenge. After receiving a prior authorization, nearly 869 million hours are spent per year!
It is true that electronic prior authorization has been in effect for more than a decade. For payers who have their own heavy web portals, however, there is a lack of better communication between two receptive interfaces, the portals, which are only associated with the individual process workflow.
What we need today is expert intervention and a combination to make the most of the technology's benefits. While it is true that a manual process is quite expensive and costs about $ 10.78 per transaction, compared to $ 2.07 for a prior electronic transaction authorization.
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Reduce the time with electronic prior authorization
Good communication between the payee and the vendor is a serious problem that becomes a major obstacle to the ideal change for more value-based care. Ultimately, solving your practice management priorities will be possible with a perfect combination of manual and electronic prior authorization that heals your pain in exam and authorization mandates as a medical practice.

With more than $ 31 billion being spent annually for prior authorization, healthcare providers need to leverage the best technology in order to accelerate the practice management process., Healthcare in general generally stays local!
Whether it's REM on the supplier side, the end-user management systems are old and often unable to keep up with changing business dimensions. The continuous data exchange between provider and payer is still hampered by unusual pay-per-view portals that correlate with their individual workflow models.

Combination of a manual/electronic process for a simplified prior authorization process
Although both systems can communicate, tuning and data absorption are not efficient enough, which makes integration rather bleak. The entire licensing process is the most important aspect of the actual sales cycle. Patient access services do not have sufficient resources to respond to authorization requests!
The Medicare and Medicaid cuts will be just another challenge, and a more rational management/management cycle management will be the reference. Appealing to all the "non-self-denials" that you face as an organization requires that you combine manual and electronic processes with a large number of resources that meets the demands of modern day practice management.

Considering that nearly 90% of previous authorizations require a call or fax, Surescripts calculates that the cost of servicing these requests is between $ 2,000 and $ 14,000 per year. Previous authorizations account for almost 2% to 4% of this revenue!
Considering that billions of recipes are ordered every year, that brings a lot of money and time! For an urgent request it can take 24 hours to make a decision, and for a standard, it can vary between 10 and 15 days!
On average, we find that physicians spend 1.1 hours a week, surgeons 0.7 hours and specialists 0.8 hours. The biggest challenge still does not take into account that different forms are associated with the prior authorization process.
For example, general care nurses spend around 13.1 hours per physician with prior authorization and 3.8 hours on forms in a given week. Electronic prior authorization provides bandwidth and allows physicians to shift their time to the highest priorities of nursing management.

This author has near about one-decade experience in prior authorization field and that's why he is interested to share his working experience on this website. Also, he is associated with one of the biggest healthcare support organization Prior Auth Online.