When you are in a healthcare business, your approach should be very detail-oriented. Once you miss a single strand of information, your business may come under the scanner and similarly, it may lead to financial pitfalls. Dealing with prior authorization—in medical billing—manifests profitability. After conducting several heavy-weight researches, prior-authorization is recommended as an essential part of medical billing and outsourcing it will escalate your business to the next level.
Prior authorization—is the process of getting an agreement from the payer to cover specific services—before the service is performed. Normally, a payer that authorizes a service prior to an encounter assigns an authorization number that you, need to include on the claim when you submit it for payment.
To run and provide malleable healthcare services to your client, pre-requisite metrics are—to become a sound player— in the field of prior authorizations, conducted through professional medical billing outsourcing teams. To dish out clean claims—which is precisely processed and reimbursed at the first time, submitted to the payer—discards conventional dogma off the desk. To bring a seamless perfection in claims correction process, in-depth efficiency is needed to boost revenue cycle.
Let’s go through a quick glance of three benefits of outsourcing prior authorization:
1. Current Procedural Terminology (CPT) codes are a key to success in prior authorization. It is mandatory to provide correct CPT codes. Often, it has been observed that, identifying correct procedural codes before the service is an uphill task. To determine the correct code, checking with the physician is a wise solution.
2. It is always advisable, better to authorize treatment not delivered than to be denied payment for no authorization. When a procedure has been authorized but is not completed, no penalty is incurred.
3. To make sure that members be given the maximum benefit available under the policy. Similarly, it will also ensure that the services being provided or being requested are medically appropriate for the condition/diagnosis and covered under your policy
Why chase claims endlessly? Let your administrative burden be resolved by proficient prior-authorization outsourcing personnel. Appointing expert personnel will increase revenue and restore your sanity. Outsourcing prior-authorization will optimize the profit levels and will outcome in rapid claims processing and on-time payments.