Prior Authorization Video
Video Transcript
Managing the revenue cycle at diagnostics and genomics labs is becoming increasingly more complex.
Reimbursements are being reduced. Test menus are growing. Access to patient benefits information at the point of care is limited. And the number of participants and steps involved in the revenue cycle is very convoluted.
This creates an environment ripe for errors, delays, redundant work, and a lot of denied claims. So, it’s no wonder that some labs are forced to write off as much as 80% of revenue as bad debt.
And now — as if things weren’t challenging enough — labs have to cope with a surge of prior authorization requirements that bog down and complicate an already complex process.
To deal with this influx, employees that could be focused on providing patient care are instead stuck faxing forms, playing phone tag, and sifting through emails.
That’s where Myndshft comes in.
We automate prior authorization and reduce manual tasks by as much as 90%. So diagnostics and genomics labs can resolve more prior auth requests, faster, and with less effort.
Here’s how it works:
First, Myndshft integrates with a lab’s existing infrastructure and works inconspicuously in the background. Existing workflows stay intact, and your staff doesn’t need to learn how to navigate new applications.
When a lab order is entered into an order entry system or LIM, Myndshft goes to work. With a library of rules for thousands of payers, Myndshft automatically synchronizes with the eligibility and prior authorization rules for all major drug and diagnostics procedures.
Myndshft automatically recognizes the identity of the patient and provider and verifies that the data submitted for a prior auth is complete and complies with rules and policies. Simultaneously, each test ordered is checked to determine if a prior authorization is required.
If a prior authorization is required, it triggers information to be collected from a LIMS or financial management system and the prior auth request is instantly submitted and intelligently routed based on the optimum route based on the payer.
In these few seconds, Myndshft also determines the reimbursement structure and calculates the patient’s exact financial responsibility for the test. Not an estimate, but the actual dollar amount due from the patient.
Myndshft then continuously monitors the status of each prior auth request submitted – saving lab staff from having to make calls, log in and out of portals or send emails to get the most up-to-date information.
All updates are automatically populated inside of a LIMS or financial management system, right where lab staff would expect to see it.
Utilizing the results from a prior auth request and actual reimbursement information from a payer, Myndshft dynamically updates automated workflows and the rules engine, reducing the risk of a claims denial in the future.
Myndshft enables labs to focus on caring for their patients and be confident that their revenue cycle is working the way it should. With Myndshft, patients can get the tests they need when they need them, leading to better diagnosis and care.
See how Myndshft can automate and simplify your prior authorization process today.
