Why it's time to re-evaluate your preauthorization strategy

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The complicated process of manually securing preauthorizations takes up valuable time and resources. It's no wonder then, that a growing number of organizations are automating their ordering systems to help providers enter imaging orders in real-time for same day results while removing the burden of manual preauthorization.
 
 

In a recent Aunt Minnie article, "3 reasons to re-evaluate your prior authorization strategy," Merge's Vice President of iConnect® Network Services, Pete Nanos, explored the top three reasons why providers should transition from manual preauthorization to an automated, streamlined process:
  1. Reduce administrative costs and claims denials. There are numerous expenses associated with resolving claims processing and payment issues. In fact, more than a third of physicians surveyed by the American Medical Association have staff who work exclusively on preauthorization.1 However, with an automated solution, providers can lower the risk of claims being denied and increase their reimbursements.
  2. Spend more time with patients. By reducing the amount of time providers spend on paperwork and requesting additional information for denied claims, they can allocate more time to spend with patients. The removal of manual preauthorization reduces the estimated 10-20 hours per week spent on claims denials, and lowers the time spent per transaction from 20 to six minutes.2
  3. Remain Competitive. As the healthcare industry continues to move toward full adoption of electronic transactions, it's imperative for providers to keep up with their competitors, prioritizing efficiency and speed. In addition, new legislative actions and government mandates will ultimately make upgrading to electronic preauthorization a requirement.

Providers must update their preauthorization systems if they want to stay ahead. With the right partner, transitioning from manual to automated preauthorization can help providers reduce costs, the time spent on administrative work, and claims denials.
 
  1. American Medical Association. Healthcare coalition calls for prior authorization reform. Marketwired website. http://www.marketwired.com/press-release/health-care-coalition-calls-for-prior-authorization-reform-2190834.htm. Accessed January 25, 2017.
  2. Ensuring a healthier tomorrow. American Hospital Association website. http://www.aha.org/content/13/healthtomorrow-report.pdf. Accessed February 8, 2017.
 

Originally posted on: 4/13/2017 2:28:29 PM

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