Facing A Nightmare with Your Prior Authorization: A One Stop Destination That Defines Your Practice

Prior Authorization Helps

It will be a pertinent approach to assess the time, delay in medical procedure and abandonment of original prescription that happens due to lack luster prior authorization practices. We can cite real time examples of prior authorization taking a toll on urologists and the patients.

A patient was diagnosed of acute Hematuria. The urologist wanted to do a cystoscopy right there in the office. But, he wasn’t able to proceed further as the patient needed prior authorization for the procedure involved. In about a week’s time, when the urologist actually obtained authorization from the insurer, the patient no longer had the bleeding and the suggested examination was denied by him!

Six months later, a bladder tumor was found. If there was no delay with insurance pre-authorization, it could have been treated promptly. 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

Over the last decade, 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.

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

We are 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

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 Services Inc. 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