Fixing Healthcare’s Broken Pre-Authorization Model

Fixing Healthcare's Broken Pre-Authorization ModelAmong the processes that influence the healthcare revenue cycle, pre-authorization stands out—and not in a good way! Most provider organizations are still managing pre-authorizations the old fashioned way: manually, with paper, pen, fax, and phone. These ad hoc methods of securing and confirming payer approval for non-emergency medical services are error-prone and inefficient, and often lead to denied or rejected claims or, worse, delays in service.

Few organizations file claims manually any longer. Why, then, are we still completing, filing, and managing pre-authorization requests as if it’s 1980? Technology advancements finally make it possible for providers to standardize and centralize the pre-auth function. Beyond the obvious time and cost savings related to reducing administrative overhead, automating pre-auth can have a significant impact on reducing authorization-related denials.

Far less busy work, a streamlined automated workflow, time and cost savings, and fewer denials to boot. What’s not to like? But how does a provider organization get from manual to automated to capture these cost savings, revenue enhancement, and most important, potentially faster time to service?

The answers are in this article published by Becker’s Hospital Review, commissioned by RelayHealth Financial: Fixing Healthcare’s Broken Pre-Authorization Screening & Verification Model. Download it now to learn what a contemporary pre-authorization process looks like, how it works, and what’s involved to get your organization started.

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