Prior Authorizations

Prior Authorization Services: A GoTelecare Success Story

If we take into account that almost 90% of the process in prior authorization either needs fax or a phone call, on an average, we find physicians spending 1.1 hours on a weekly basis, surgeons spending 0.7 hours and medical specialists spending 0.8 hours.

♦ The biggest challenge, it still does not take into account that different formularies that are interlinked with the prior authorization process. The costs of completing this request estimates to anywhere from $2000 to $14000 per year.

♦ The standard range of responding can take anywhere between a tentative time frame of 5 to 15 days. Considering that there are billions of prescriptions ordered every year, it adds up to a huge expense and time wasted.

Imagine a patient visiting a pharmacy and discovering that a medication needs a pre-approval! It is one of the biggest negatives and with the modern shift to a more value-based care approach; it is an absolute no-no for a practice!

Automation across the prior authorization services is becoming pertinent with more healthcare providers looking to favor a paperless ambiance that will help them in reducing surging costs.

A disciplined process with skilled resources and immediate understanding of the claims adjudication mandates provides transparency in eligibility verification and authorization.

It is important to lay down precise checks and balances that streamline the entire revenue cycle management priorities in best proportions.

Reducing delay in first time requests in prior authorization can be solved with robust processes and sound electronic prior authorization software that will help in building up a strong case for a provider. Finding a specialized partner that innovates and adds value by providing state of the art platforms that reduce time in precertification is going to lay down a strong footprint.

In Excellence We Trust: The GoTelecare Value in Prior Authorization

To comply with the emerging requirements, we have developed a perfect platform for you to submit your prior authorization requests online. Over the years, we have worked with leading providers and payers and our rich understanding of claims adjudication mandates of the industry helps you with customized eligibility verification and authorization assistance.

Our objective is to simplify the entire prior auth process and help you get results in quick TAT with the help of a proactive platform. Our desired approach will be to simplify the entire prior auth process and help you get results in quick TAT with the help of a proactive platform. We believe in performing task specific activities in eligibility verification, authorization, denial management and accounts receivable support.

Our experts are ready to share with you our success stories with creating an excellent back and forth mechanism, great case studies of managing communication with provider/ payer office.