It is quite evident; the manual process can never be the solution. Effective payer provider communication, processes that work together and is responsive is the answer. Electronic prior authorizations statistically resolves many of the cost challenges with only costing $2.78 per transaction as opposed to $`10.78 in a manual process.
Instead, it is much more important to have synchronized combination of manual and electronic prior authorization. Manual entry of data, unending phone calls with prior authorization is already costing the US healthcare industry $ 32 billion.
Nearly, 869 million hours are getting wasted on just obtaining prior authorization. Almost 90% of the prior authorizations either require a phone call or a fax, Surescripts estimates the cost of completing these requests to range anywhere between $2000 to $14000 per year. Prior authorizations account for almost 2% to 4% of these prescriptions!
Considering the fact, that there are billions of prescriptions ordered every given year, it adds to huge money and time! With an urgent request, it can take 24 hours for a decision and with a standard, it can range anywhere from 10 to 15 days!
Despite widespread adoption and also having an electronic standard in the prior authorization (EDI 278) for almost a decade, complexities, especially at the local level, have hampered a meaningful transition. Healthcare facilities for the most part are fundamentally local. It essentially implies that local contractual agreements, provider networks, information systems that are outdated, are still to go a long way for a seamless transaction of data that reduces time and speed!
Sunknowledge Services: Our answer to prior authorization challenges
With our proprietary platform, “Prior Auth Online” Sunknowledge Services Inc is a one stop destination for stand out prior authorization assistance. We do it all, right from gathering of procedural information, contacting the physician office for necessary information, connecting with the insurance companies and updating the auth outcome in the PM/ billing system.
Our team is well versed across all major practice management / EMR systems. Let us share with you, our best practices and we assure you of seamless communication standards. Leverage the Sunknowledge Services Inc opportunity in prior authorization to lay down the right checks and balances.