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How to ensure a succcessful authorization process

Gone are the days where authorizations were less of a requirement.

 

According to a 2019 study from the American Medical Association, 86 percent of physicians report that authorization burdens have increased during the last five years and 43 percent claim they have ‘increased significantly’. Fast forward to Q3 2020, we believe authorizations are required more than ever before due to COVID-19.

Then there is also the delay aspect of the authorization process: 64% of physicians wait one or more business days for receiving approvals and 91% state that this process leads to delays in accessing necessary care!

Remember it is your responsibility as a practice to keep track of which procedures require authorizations on a consistent basis.

5 tips that will ensure a successful authorization process.

1.

Keep in touch with payers

Maintain consistent communication with all payers on which procedures require pre-authorizations and consider creating a pre-authorization database. Make one person responsible for this database and keep it updated periodically as this will help reduce confusion and improve efficiency.

2.

Verify procedure authorizations with the right person

Never assume that a service does not require an authorization unless you have proof from a senior level employee on the payer side.

3.

Record conversations

Make sure all authorization requests are captured on a recorded line.

4.

Take notes of who you talk to

If an agent tells you that a procedure does not need authorization contrary to what your records state, take the agents name, phone number, employer id and reference number for the call. This will aid in your appeal should the claim deny for no authorization.

5.

Submit requests ahead of time

Ensure to submit your authorization request at least a week before the procedure if possible to avoid any inconvenient delays for your patient.

Call us now to get a free evaluation of your authorization needs!

Dial (954) 243-9079 or click on below link to fill out our form and we will get back to you.

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An authorization is not a guarantee of payment but it will most likely result in a claim denial if you don’t get one.

Luis Nicot

CEO, SkyCom Healthcare

Clients we proudly serve

Contact us now!

Call us at (954) 243-9079 now to learn more about how SkyCom Healthcare can contribute to improve your customer journey or fill out the form below and we will be in touch!

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