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
In the last decade, the revenue healthcare providers collect directly from patients climbed from 10% to 30%. Now that patients have more skin in the game, so to speak, their expectations have changed. They want price transparency, convenience, and personalized experiences. To top it off, they’re willing to shop around for a different provider or insurance plan if you fall short on those expectations. Who do they blame when a cumbersome prior authorization process leads to care delays or preventable denials? You. How do you provide a more streamlined, less frustrating patient/member experience? With prior authorization software. Healthcare consumerism has… Read entire article here
