One of the pertinent reasons, to consider GoTelecare as your trusted partner for prior authorization services, will be our understanding of the claims adjudication mandates of the industry better than any other RCM company.
♦ We believe that using state of the art technology that reduces time and error in auth submission will be crucial. Our proprietary platform has been developed to meet your everyday auth requirements.
The average says that a practice spends $65,000 a year for PA’s and yet faces almost a 40 percent denial due the complexities in policies of approval. It is pertinent to take the assistance of a billing company that understands modern practice management priorities. A streamlined electronic prior authorization platform that integrates well with the EMR should be the idea.
Prior authorization demands of a medical practice make them vulnerable to administrative malpractices.
We are currently providing exclusive prior authorization services in DME for as low as $5 per auth. We will be covering all the necessary elements in practice management that includes:
Gathering of information
♣ Patient information: Name, DOB, Insurance
♣ Ordering provider’s information: Name, NPI, TaxID, Address, Phone#
♣ Check whether ordering physician is PECOS certified
♣ Place of Service
♣ Service codes
♣ Diagnosis codes
♣ Units for each service code
Contacting the payer
♣ Determine the process for prior authorization request submission, i.e. portal, fax, phone etc.
♣ Contact for UM/Prior Authorization department
♣ Fax to send medical notes (if required)
♣ Expected turn-around time
♣ Limitations/exceptions (if any)
Our predetermination, initiation and follow up activities include
♣ Check to determine whether patient is eligible based on payer requirements for Prior Authorization
♣ Initiate prior authorization request as per payers’ guidelines / protocols
♣ Follow-up with payer via outbound calls, portal etc. to check authorization status
♣ Follow-up with ordering physicians’ offices for medical notes, therapy charts, other documents etc. (if required)
♣ Provide additional documents/information if requested by the payer
Update Authorization outcome in the PM/billing system. The information will include:
♣ Date range
We also provide additional services in AR collections, AR recovery ,denial management support with superior account management standards. We have top class references from leading industry peers on how we have reduced their costs of billing by 80% and increased collections by 97%.