Best Practices in Healthcare Prior Authorization
Gearing up to tackle Prior Authorization
Even as the debate over Prior Authorization continues to rage – on whether the process is really necessary for ensuring a better and safer patient outcome, or if it simply exists to disrupt the timely dissemination of healthcare services – we are not yet ready to shake it off completely. Till a clear verdict is out, the best one can do is to follow the best practices in the industry to ensure the most favorable results from their prior auth efforts.
What follows is a brief list, by no means an exhaustive one, of practices that have been seen to yield the best outcome in Prior Authorization matters. The process has been criticized time and again for putting a heavy strain on human resources and business time. With these best practices in place, providers can hope to accomplish more in less time. Let’s peek in.
Getting the most out of Prior Authorization
A great place to start building a better Prior Authorization experience is ensuring clear and open communication with your patients, healthcare providers, and insurance companies. This helps to avoid any confusion or misunderstandings that could lead to delays in treatment. Couple it with ensuring that you have complete and accurate documentation, which includes all necessary medical records, test results and treatment plans, and you could be well on your path to attain PA glory. It is important to remember in this respect that all documentation needs to be submitted in a timely manner to avoid any delays in obtaining the sought approval.
A few words must be said about using technology to make lives easier. Simply stated, electronic prior authorization tools and systems to streamline the process and reduce the risk of errors, have made Prior Authorization faster and more efficient over the last few years. So providers are strongly advised to explore the possibility to automate manual processes as far as possible as such a move can produce rich benefits in the long run.
Last but not the least, it is also important to educate your patients about the prior authorization process. Explain the importance of the process and how it affects their medical treatment. This helps to create a better understanding and reduces any confusion or frustration.