Trouble getting prior authorizations over the finish line? Every day, your staff and clinicians face one hurdle after another in pursuit of approvals. First, digging through paper or portal documentation to determine prior authorization requirements. Then, phone calls to payers—frustrating hold times included—when you have questions. Finally, gathering and submitting the documentation needed (finger’s crossed). Even tracking the progress of prior authorization requests breaks your stride, forcing you to navigate between multiple payer portals to determine the status of everything in play. Enter the game-changer: prior auth software that streamlines this process and accelerates patient care. Become a prior auth… Read entire article here
Every year since 2016, Medical Group Management Association (MGMA) members have reported an increase in prior authorization requirements. The volume alone poses a big challenge. Add in constantly changing payer policies and keeping pace with the volume becomes even more challenging. Prior auth software overcomes those hurdles by making the information you need more accessible. New prior authorization policy ignites concerns Beginning June 1, UnitedHealthcare plans to introduce prior authorization for colonoscopies. The March announcement, which ironically took place during Colorectal Cancer Awareness Month, ignited concerns among gastroenterologists who say the new policy creates barriers for patients seeking surveillance and… Read entire article here
Recently Ochsner Health cut 2% of its workforce, pointing a finger at reimbursement rates that have failed to keep pace with inflation. Ochsner isn’t alone. Many healthcare providers face a similar dilemma, especially now that the Public Health Emergency (PHE) has ended. As a result, many healthcare providers have targeted mostly management and non-clinical roles in their layoffs. Unfortunately, that means fewer staff to manage the ever-growing burden of prior authorization. That’s where end-to-end prior auth software can help. Why downsize when you can upgrade? With the increasing pressure to streamline operations and reduce costs, healthcare providers confront the difficult… Read entire article here
Moving from fee-for-service to a value-based care model requires a significant change in perspective. What’s one of the most critical changes that needs to take place? Efficient, seamless exchange of patient, provider, and payer data. Unfortunately, healthcare relies on complex data ecosystems and struggles with data silos—a hurdle that hampers the full realization of the value-based care approach. Prior auth software makes short work of data silos, in the process creating momentum for transitioning to value-based care. Prior auth software enables interoperability Data silos occur when data is stored in separate systems, making it difficult to share information across different… Read entire article here
