Prior Authorization Woes and Best Practices For a Better Synchronization

Reduced errors with duplication and errors with patient information help in maximizing claims reimbursements. Faulty practice management standards are a major reason why most healthcare providers fail to address their patients in a timely manner. An alarming amount of time and money is getting wasted with the lengthy administrative process. It is true that prior authorization consumes a huge amount of a physician time, nursing staffs, and front office executives.

Wait times with prior authorization!

A survey was done with medical practices and questions were raised to them. Almost 26% suggested that they waited for a bare minimum of 3 business days while 60% said that they had to wait for at least 1 business day for a prior authorization decision. Prior authorization burdens can be quite killing on a medical practice. Almost 75% physicians responded by saying that conducting prior authorization is hugely taxing responsibility for most.

The average cost of prior authorization ranges between $2.161and $3,430 annually. While it is true that prior authorization was designed for patient relief, it has become a major hindrance for both providers to render fast and effective care and the patient to receive treatment. A huge amount of issues with prescription abandonment, medical procedure delays are a major instance that prior authorization is a huge pain area.

A recent survey done over a quantum of 1000 physicians, it was recorded that for just completing the requirements of prior authorization, it takes almost 16.4hours a week. 853 hours get only consumed with tasks of prior authorization. It is almost 37 times a week that you or your administrative staff handles prior authorization requests! It is a cumulative average and will be something that has to be addressed if value-based care is to be achieved.

It is true that 90% of the prior authorization process requires either a phone call or a fax. The cost of completing the PA requests will be around $2000 to $14,000 per physician/ per year. If we take into account that almost 4% of all of it is prescriptions with billions ordered every year, a huge amount of money and time gets consumed. A focus on a patient-centric model gets greatly compromised.

SunKnowledge: The next-gen prior authorization destination

Rendering task specific/stand-alone services in eligibility verification and prior authorization, SunKnowledge Services Inc is a champion practice management company. At just $5 per auth, we will be providing acomplete prior authorization action plan by working as your ultimate operational extension. Dedicated account management/customized reporting are guaranteed without any further costs. Let our experts share with you our best practices. We are your reliable growth partner. We are also providing our free telemedicine support alongside our end to end revenue cycle management assistance.