Prior Authorization Challenges and Your Best Practices for Streamlining it

Prior Authorization Service

It is true that prior authorization can be more frustrating than other processes of administrative nature. Maximizing your claims reimbursements in a rapid turnaround time with reduced data errors and duplication, assigning the staffs to work for a better practice management, all contribute to a length process that kills patient engagement time. Ultimately, the patients that are supposed to receive the benefits of the process, bears the brunt and delays in medication and procedure abandonments.

Prior Authorization wait times a worry sign

Questions were asked to practices on how long they had to wait for a PA decision. 26% waited for at least 3 business days while nearly 60% reported waiting for at least 1 business day! This is an indication of how much practices has to suffer with prior authorization burdens. The cost of prior authorization is $2,161 to $3,430 a year. Nearly 75% of the patient classified prior authorization as a high or extremely taxing responsibility.
According to the insurance industry, prior authorization is a shield from drug abuse, restricting access to costly therapies and services. But ultimately we find the patient suffering from poor standards of communication between the provider and the payer!

Sunknowledge improves your financial performance and goes beyond just processing data

Ever since its inception, we have been a pioneer revenue cycle management company offering our end to end expertise in eligibility verification, prior authorization, claims submission, denial management, accounts receivable recovery, payment posting to leading providers across more than 28 specialties including : DME’s, Orthotics and Prosthetics, Alcohol and Substance Abuse, Mental Health, Dermatology, Skilled Nursing Facilities, Specialty clinics and pharmacies, Physician practices, radiology centers, Cardiology, Physical, Occupational and Speech Therapy and others.

We explore your pain areas with our stand-alone prior authorization support, with an extensive understanding of claims adjudication priorities of the payers. Sun Knowledge is currently working with leading insurance payers; MSO’s helping them in their credentialing, adjudication mandates.

No other medical billing and collections company is suited to handle all your practice management needs with a no-nonsense approach like us, best practices that help you lay down checks and balances. Our team will be taking care:

♦ Gather vital information on medical procedure, patient, and provider
♦ Verify and validate prior auth request with effective payer side communication
♦ Check the patient’s eligibility
♦ Initiate the auth request based on the payer mandates
♦ Checking the auth status
♦ Collating relevant documents from the ordering physicians/follow up
♦ Providing additional information if any
♦ Update the auth income in the PM/Billing system

Ask our experts, let us explain you with a complete demonstration of our web-based portal “prior auth online” provide you access to a pool of expert practice management team, fluent with any billing tool in the marketplace. We desire to work as your ultimate operational extension. At just $5 per auth, SunKnowledge sets the benchmark with cutting edge prior authorization solutions.

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What Customers Say

  • Thank you again for your efforts - your team continues to meet our expectations and is actively improving our ability to serve our patients. Your efforts specifically to maintain open communications with our team has fostered the success of this effort and we look forward to expanding the effort next week and beyond.

    Project Manager at a leading Prosthetics & Orthotics company based in Florida
  • I was always against the idea of outsourcing our back-end claims processing work but I was wrong. You have provided extraordinary deliverables on a timely basis which led to cost cutting considerably for us.

    CEO of a leading MA-PD Plan
  • We upload charts to a secure FTP server and they take it from there. The staff is knowledgeable and very easy to work with. Any issues that we have faced have been resolved within a few days.

    A major orthotics & prosthetics practice based in the south-east