Streamlining the Prior authorization process for healthcare providers has always been one of the most intricate, resource-intensive, and complicated tasks for years. No real collaborative efforts have been seen from the stakeholders to make this complex process efficient and effortless for patients and healthcare service providers.
The 2023 prior authorization physician survey conducted by the American Medical Association quoted almost 64% of physicians and healthcare providers saying that they had to face long delay times, approximately 24 hours, for payers to settle on prior authorization and that delay ultimately affects patient health.
Therefore, a comprehensive knowledge and deep understanding of Prior Authorization services is essential for healthcare providers to enhance patient care services and increase authorization approval. We can understand the intricacies and difficulties involved at every stage of the process. But why fear when you have Scribe Runner here, your virtual Prior Authorization service provider, known for higher approval rates?
Seeing the importance of time in this fast-evolving era, physicians need to implement an effective strategy that is simply the prior authorization process. In this blog, we will discuss the top 5 strategies that will help you to streamline your process more smoothly.
Understanding Prior Authorization and its Impact on Patients, Providers, and Payers
Prior authorization is a necessary process for healthcare providers but it often becomes a cumbersome process. because physicians require approval from the insurers before administering certain treatments, which commonly involves verifying the necessity of medical treatment and cost-effectiveness.
However, the process takes too much time and results in delays that can negatively impact patients, leading to a negative impact on the patient’s health.
On the flip side of the coin, when we talk about the providers, the administrative burden diverts time and focus from patient care.
On the payer side, Prior authorization helps them manage costs but sadly they often do not care about the delays that often cause delays in timely treatment.
But there is always a better solution for every problem, By understanding these challenges, providers can explore solutions like outsourcing PA to virtual services, which will reduce the delays and improve patient care.
5 Best Ways to Streamline the Prior Authorization Process
The prior authorization (PA) process is a critical checkpoint in healthcare, but it often leads to frustrating delays and administrative burdens for providers and patients alike. Here are five proven strategies that can help streamline the process and improve efficiency:
1. Incorporate advanced Technology and Automation
Your healthcare team has a lot of work to do and in the healthcare sector every task has equal importance, you can’t wait too long for approval to complete the process. So, to avoid doubling their compliance efforts, Healthcare providers need to come out of the outdated and manual way of prior authorization.
Switch to the Electronic prior authorization process, will automatically reduce the delay time, add efficiency, and ensure compliance with payer requirements.
2. Implement a Gold Card System
The Gold Card system is a process that is particularly designed for those providers who have a higher success rate in obtaining higher prior authorizations. What is done by following this strategy, using evidence-based guidelines, and seeing the higher approval percentage, providers can receive exemptions from Prior Authorization requirements which ultimately allow such doctors, healthcare, and physicians to bypass the process for most patients.
What benefits does it bring for patients and providers? Well, this gold card system reduces delays time, allows doctors to pay attention to patient care, and saves administrative time for better healthcare service In this system, both the payer and provider benefit from increased trust and efficiency.
3. Streamline Workflow and Enhance Communication
Having a compliance team that is excellent at communication between the healthcare providers and payers on services that need prior authorization would not only make the process smooth but also quick with a higher approval rate. One great way is to Complete encounter notes within 48 hours to avoid bottlenecks in the approval process.
Because clear communication between healthcare providers, payers, and patients is essential. You must ensure that your team is getting Regular updates on required documentation, open lines of communication for clarifications, and proactive communication with payers that can ultimately reduce delays and errors that often slow down the PA process.
4. Centralize and Track Authorization Requests
Though decentralized systems often work very well in most business structures, but this formula does not fit in Prior authorization process. because Implementing a centralized system for tracking and managing prior authorization requests is crucial for preventing missed deadlines and unnecessary delays.
You must have a system for a robust tracking system that can help healthcare providers monitor each request’s status, follow up when needed, and ensure that no important steps are misseen.
By automating reminders and tracking all documentation in one place, providers can focus more on delivering care and less on administrative follow-ups.
5. Outsource to Prior Authorization Experts – Scribe Runner
For many healthcare service providers, managing the administrative burden of prior authorizations in-house often becomes difficult and resource-intensive. So, what is the solution?
One great way to avoid delays improve efficiency and increase the approval rate is to Outsourcing prior authorization tasks to dedicated service providers like Scribe Runner, which will help reduce delays, minimize errors, and free up staff to focus on patient care.
Outsourcing prior authorization services to Scribe Runners means you are making partnerships with firms’ experienced medical teams who are experts in navigating payer policies and expediting the approval process. This ultimately improves your overall efficiency of healthcare practices.
Final Thoughts
The prior authorization process doesn’t have to be a major obstacle for healthcare providers. The strategies discussed above will, in most cases, help physicians and the broader healthcare sector.
However, if your challenges go beyond these strategies, ScribeRunner is here to assist. We specialize in handling complex healthcare scenarios, including medical billing and prior authorization issues. Partner with us to make your prior authorization process smoother, and more accurate, and achieve near 100% approval rates.