The process of prior authorization is the most challenging and difficult process in any healthcare billing services. A successful prior authorization process not only helps in lesser denial claims but also elevate your cash flow as well. PriorAuth Online an age-old authorization platform for authorization initiation approval and follow-up is the perfect operational extension for all radiology, specialties pharmacies, genomic lab, HME prior authorization etc.

The Four Successful Prior Authorization Steps Followed by our PriorAuth Online:

Authorization initiation- here information is collected which is necessary for the treatment process. This then is followed by authorization initiation. The information which is collected includes patient name, DOB, ordering provider’s name, NPI, Tax ID, address, phone no along with insurance information. We also ensure a proper check on the diagnosis code, units for each service code, if ordering physician is PECOS certifies or not

Requesting authorization - this is the most important part where documentation is been completed accurately collected, verified and validated along with the authorization request. In this process, it is important to maintain constant oversight over all prior authorization requests that are outstanding

Continuous follow-up is made - our second last steps ensue investigating to resolve whether the patient is eligible based on payer requirements for prior authorization. Once this is done prior authorization is initiating through outbound calls, portal etc as per payers’ protocols/guidelines. Here waiting on the approval or denial of their request for ongoing authorization happen

Updating the authorization process- This concludes with providing additional documents/ data if requested by the payer. This ends up updating the HME prior authorization results in the billing system.

A Successful Way Out:

For successful revenue generation maintaining and obtaining a proper prior authorization is very vital, as denial claims and rejections not only deteriorate the revenue generation but also waste a lot of time and effort during the process.

PriorAuth Online powered by Sunknowledge Services Inc, has clients all over the US for its effective HME prior authorization solution and even for increasing the prior authorization rate by 1.5-2x. Ensuring 100% prior authorization on the same day and reducing the operational cost by 80% PriorAuth Online have earned excellent industries reference and more than 100 clientele list.

For a tailored customized effective solution along with streamline operation and financial upliftment, PriorAuth Online is the perfect one-stop destination for all your problems.

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