In the complicated prior authorization business, collection of relevant documents for the prior authorization process and staying up to date with the process of prior authorization is two of the important factors for a successful prior authorization process.
Collection of documents – in an HME Prior Authorization procedure collecting relevant and needed documents for the process becomes very essential as the chance of denial depends on it. Any misinterpretation of information can cause huge damage to patient’s health, loss of time and even money.
Up to date with authorization – the person involves in this authorization process should also be up to date with the changing authorization rules and regulation; this also decreases the chances of errors and denial in all your HME prior authorization and also for other authorization too.
Here outsourcing operational extension like PriorAuth Online, powered by Sunknowledge Services Inc a medical billing solution is a perfect fit for HME prior authorization.
Our Successful HME Prior Authorization Process Follows:
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Collection of information – it starts with the collection of required information necessary during the process. This 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.
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Reaching Payer – in this process fax phone etc is used to verify and validate authorization request submission. Once this is done we reach to UM/Prior authorization department and even fax medical notes (if required).
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Initiating and Follow up – our last steps ensure 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. This concludes with providing additional documents/ data if requested by the payer. With our experts updating the billing system.
We Also Excel in Standalone/End to End Billing Services with a Service Charge of $7 Per Hour for:
- Rx Order Entry
- Patient demographics & insurance entry
- Product Code/Rx & Dx Entry
- Eligibility verification/Authorization
- Collection of complete Rx
- Collection of documents for Auth approval
- Submission
- Rejection/denial management
- A/R Follow-up
So call our expert over a ‘no commitment call‘ and see how effectively our experts can help you in streamline operation along with financial upliftment for your HME prior authorization and also for other authorization too. Partnering with us will not only help you with robust reporting, 80% operational cost reduction but also 24*7 no cost dedicated account manager and a no binding contract.
