Prior authorization is a health plan utilization-management or cost-control process that requires physicians to secure pre-approval before a prescribed treatment, test or medical service qualifies for payment. On average, the AMA has found that practices must complete 41 prior authorizations per physician each week.
Our third video in our five-part series on revenue cycle management processes explains how to prepare your staff to request pre-authorizations from payers and avoid what can be a costly source of denials. Make sure you watch part one and two for more tips and insights.
Read the “Missing Prior Authorizations” video transcript below and subscribe to Madaket Health on YouTube.
Hello folks, Devon here with Madaket Health! Today’s Madaket Minute topic is a continuation from the last couple of videos that we’ve had about front end revenue cycle processes that lead to poor revenue cycle management and what you can do to remedy these problems.
Today we are on tip number three: missing prior authorizations. More and more payers are requiring these, and if you haven’t noticed in the news lately, it’s continuing to be an issue and a source of denials. Whichever person in your office handles this, make sure you give them direct access to payer portals in order to request that pre-authorization, if at all possible. Handling pre-auths over the phone is not a good use of your staff’s time.
Your staff also needs to have current information of what services and procedures require pre-authorizations in your office. Make sure to put this in your practice management software and give them a hard copy cheat sheet if that’s easier for them. I’ll be sharing my last two tips in my upcoming videos. In the meantime I’d love to hear any of your challenges or solutions that you found to improve your revenue cycle management. Have a great one!