Authorizations allow medical practitioners to ensure that specialized appointments or procedures will be covered by health insurance companies for their patients. Health care providers must often demonstrate a need for the health care services in question in order to get insurance prior authorization. Prior authorization may be needed to cover computerized tomography (CT) scans and magnetic resonance imaging (MRI) as well as ultrasounds or cancer treatments. The diagnostic tests alone can run up health care bills and lengthen the time needed to usher a patient through their health care treatment.
Insurance prior authorization can present a drain on the time and resources of a hospital or health care clinic, especially when health care providers must spend hours providing evidence that a health care service is vital to the patient. The process may also involve billing professionals and health care receptionists and it could even involve in-depth conversations with the patient. From diagnostics to surgeries and treatment plans to expensive medications, it can be difficult to get a health care insurance provider to sign off on procedures.
Automated prior authorization offers health care practitioners the option of automating this process through computer technology in order to obtain insurance prior authorization. Through automated authorizations, medical professionals can simply note the need for an insurance authorization through assigned appointment types or procedure codes. The automated prior authorization technology then runs reports against the daily schedule at any given practice in order to find appointments that may require pre-authorization in health insurance. With the help of a prior authorization specialist, the process then produces the necessary insurance authorizations within 24 hours. The authorization number can be included in a patient’s chart in order to streamline the process for health care practitioners.
Although pre-authorization in health insurance is generally not needed in emergency situations, it presents obstacles for everyone involved in a patient’s care. Streamlining the process through automated authorizations will not only save money for the health care organization but it could also lead to better outcomes for the health care practitioner and the care they are able to provide to their patients.