Unlocking The Secrets To Successful Prior Authorization For SNF

UNLOCKING THE SECRETS TO SUCCESSFUL PRIOR AUTHORIZATION FOR SNF

DID YOU KNOW?

AS PER AMERICA’S HEALTH INSURANCE PLANS (AHIP), PRIOR AUTHORIZATIONS ARE REQUIRED TO MAKE SURE THAT THE PATIENT RECEIVES A SAFE, MEDICALLY NECESSARY, AND SUITABLE TREATMENT.

HEALTH INSURANCE COMPANIES HAVE THE DISTINCT ADVANTAGE OF OBSERVING HOW PATIENTS USE THEIR COVERAGE AND WHAT TREATMENTS THEY HAVE ALREADY AVAILED. THE PRIOR AUTHORIZATION PROCESS HELPS AVOID DUPLICATION AND UNNECESSARY TESTS AND TREATMENTS WHILE ENSURING THAT THE PATIENT RECEIVES THE BEST CARE POSSIBLE FOR THEIR CONDITION. THOUGH PRIOR AUTHORIZATIONS ARE REQUIRED IN HEALTHCARE, THEY CAN BE COSTLY FOR PRACTICES AND FACILITIES SUCH AS SKILLED NURSING (SNF).

Let’s unlock the secrets to successful prior authorization for SNF:

• EDUCATE ON DOCUMENTATION REQUIREMENTS

IT IS CRITICAL THAT PHYSICIANS UNDERSTAND THE PATIENT’S PRIOR AUTHORIZATION PROCESS.

THEY SHOULD BE AWARE OF THE PATIENT’S INSURANCE COVERAGE AND WHOM TO NOTIFY IF THE PROCESS CHANGES IN THE MIDDLE OF THE PROCEDURE. HOWEVER, THEY SHOULD ALSO BE TRAINED ON THE ENTIRE PROCEDURE AS THEIR DOCUMENTATION IS SO VITAL TO THE PROCESS.

• COLLECT ACCURATE INFORMATION

PATIENT INTAKE IS FREQUENTLY THE ROOT CAUSE OF MISSING PRIOR AUTHORIZATION, SO BE SURE

ALL THE INFORMATION YOU COLLECT FOR PRIOR AUTHORIZATION IS CORRECT. MAKE SURE YOU USE THE SAME EXACT SPELLING FOR THE PATIENT’S NAME AND ADDRESS ON THE PRIOR AUTHORIZATION AS YOU DO IN YOUR SYSTEMS.

• WORK ON YOUR DENIALS DENIALS ARE INCONVENIENT, BUT THEY CAN BE TURNED INTO A LEARNING OPPORTUNITY.

WORKING THROUGH YOUR DENIALS WILL ASSIST YOU IN AVOIDING THEM IN THE FUTURE. TO

DETERMINE WHY THE DENIAL OCCURRED IN THE FIRST PLACE, YOUR PRACTICE MANAGEMENT SYSTEM SHOULD INCLUDE DENIAL REPORTS. LOOK FOR PATTERNS IN THESE REPORTS TO FIGURE OUT WHAT HAPPENED. THEN, COLLABORATE WITH YOUR PMS/EMR VENDOR TO DESIGN A SYSTEM THAT MAKES YOUR SOFTWARE WORK FOR YOU. CREATE REPORTS, FOR EXAMPLE, THAT ALERT YOUR TEAM TO COMBINATIONS OF PAYERS AND PROCEDURES THAT REQUIRE PRIOR AUTHORIZATION.

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Outsourcing Prior Authorization to Speed Up the Process!

UNDOUBTEDLY, MOST PATIENTS ARE WAITING FOR PRIOR AUTHORIZATION, AFFECTING THEIR CARE.

THAT’S WHY IT’S VITAL TO GRANT PATIENTS PRIOR AUTHORIZATIONS AS SOON AS POSSIBLE – SO YOU WILL BE PAID, AND YOUR PATIENTS CAN OBTAIN THE CARE THEY REQUIRE.

THE GOOD NEWS IS THAT YOU CAN LESSEN YOUR PRIOR AUTHORIZATION BURDEN BY ORGANIZING YOUR WORKFLOW, EMPHASIZING DEVELOPING RELATIONSHIPS, ENHANCING ACCURACY, AND KEEPING DILIGENT. ALL THIS IS POSSIBLE BY  OUTSOURCING SNF PRIOR AUTHORIZATION TASKS TO THE COMPANY, LIKE 24/7 MEDICAL BILLING SERVICES. IN FACT, OUTSOURCING IS AN EXCELLENT APPROACH TO CONNECTING WITH PROFESSIONALS AND EXPERTS WHO MAY HAVE SOLUTIONS YOU HAVE YET TO TRY.

About 24/7 Medical Billing Services

24/7 Medical Billing Services is the nation’s leading medical billing service provider catering services to more than 43 specialties across the entire 50 states. You can rely on us for end-to-end revenue cycle management. We guarantee up to 10-20% increase in the revenue with cost reduction of your practice for up to 50%.

https://www.247medicalbillingservices.com

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