Prior Authorization Challenges Eliminated with The Sunknowledge Experience

Prior Authorization

Facts clearly illustrate that the doctor’s net take home is only 10% of the entire healthcare expenditure. While compared to the $360 billion being spent for the administrative costs, the cut of 10 percent will save only $24 billion, a quite modest saving, according to the CMS (Centers for Medicaid & Medicare Services). It is a proven estimate that almost 85% of the excess overhead can well be attributed to the insurance system.

A big reason for this is the local nature of healthcare. Proper reconciliation and absorption of data in a meaningful manner is still not quite as effective. Administrative costs are in the range of 25-30% percent of practice revenues with insurance-related costs amounting to 15%.

For a total of 430 hours, a study was done on 57 physicians across internal medicine, orthopedics, cardiology, and family medicine conveyed that while 27% time was spent on seeing the patients, nearly 49.2% was spent doing paperwork.

In a decade paperwork has gone up from being a large number to a majority chunk of a doctor’s time! The biggest pain: patients wait while a doctor spends time explaining why a CT scan must be pre-authorized!

Setting the benchmark in practice management: The Sunknowledge approach

Sunknowledge Services Inc provides comprehensive support in and is best suited to handle all your practice management needs with a no-nonsense approach, 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

We have been a pioneer revenue cycle management company offering our complete 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 many more.

At just $5 per auth, Sun Knowledge sets the benchmark with cutting edge prior authorization solutions. 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.

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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