Prior authorizations are a necessary but time-consuming part of managing a healthcare practice. If not handled promptly, they can delay care and frustrate patients. Many medical practices turn to prior authorization companies to help them manage the process. They can take the burden off your staff and help you tackle the piles of paperwork that come with insurance-related tasks.
Once you’ve decided to outsource, you’ll need to find the right partner. Here’s what to look for in prior authorization companies.
Prior Authorization Companies: What to Look For
Expertise in Prior Authorizations
Insurance rules are complex, and every payer has different requirements. The best prior authorization companies employ well-trained associates. These employees understand medical policies, payer guidelines, and how to submit approvals correctly. This reduces denials and helps patients get the care they need without unnecessary delays.
Ask potential providers about their experience with different specialties and insurance networks. A strong company will have team members skilled at navigating the process.
A Fast and Reliable Process
Delays in prior authorization can disrupt treatment plans. A good outsourcing partner should be able to process requests quickly, ensuring that approvals don’t hold up patient care.
Look for a company that prioritizes:
- Timely submissions to reduce waiting times.
- Accurate documentation to avoid unnecessary denials.
- Persistent follow-ups to push approvals through faster.
HIPAA-Compliant Operations
Prior authorization involves handling sensitive patient information. To protect patient privacy, any company you work with must follow strict HIPAA compliance guidelines.
Check that the company has:
- Secure data systems.
- Trained staff who understand compliance regulations.
- Clear protocols for safeguarding patient information.
Seamless Integration with Your Practice
The right prior authorization companies will function as an extension of your team, not as a separate entity. They should be able to work within your existing systems to ensure a smooth workflow.
Look for companies that:
- Integrate with your EHR and scheduling systems.
- Follow your practice’s communication preferences.
- Provide regular updates on the status of authorizations.
Trained and Managed Associates
One of the biggest advantages of outsourcing is that the company handles recruiting, hiring, and training. This eliminates the burden of hiring in-house staff. A good outsourcing partner will:
- Hire specialized professionals with healthcare experience.
- Train associates in payer-specific policies.
- Monitor performance to maintain quality.
Transparent Pricing and ROI
Cost is always a factor when outsourcing. Hiring in-house staff means paying salaries, benefits, and training costs. Outsourcing, on the other hand, is a more cost-efficient option. Look for companies that offer clear pricing without hidden fees.
The outsourcing company will take care of the time and expense related to hiring, training, and people management. This provides an important return on your investment—removing hassle and headaches.
A Smarter Way to Handle Prior Authorizations
Prior authorizations shouldn’t slow down patient care. The best prior authorization companies can help your practice get approvals faster and free up staff to focus on other matters.
Oclinicals provides professional prior authorization services tailored to medical practices. Our team handles everything, so your staff doesn’t have to.
Contact us today for a free consultation!