Streamlining Prior Authorizations 

Many physical therapy organizations are looking for ways to streamline the prior authorization process. Improving this complex procedure could help practices minimize the amount of time spent handling authorizations and improve the quality of the patient care provided. Additionally, physicians and other care providers may be better able to manage their workloads and improve their professional satisfaction. The following five suggestions for making improvements to prior authorizations have been outlined in a statement released by six major groups in the healthcare industry.

1. Consistent Reviews of Medical Authorizations 

It has been recommended that the healthcare system should review the services and medications that require prior authorization on a regular basis. This would allow for identification of treatments that need to be reclassified. For example, a therapy that is denied very rarely during prior authorization or a practice that is typically utilized in a uniform manner may no longer need to undergo this process.

2. Continuity of Patient Care 

Another recommendation stated that continuity of care is extremely important when trying to improve authorization methods. According to the statement, focusing on continuity of care will force the healthcare system to find new ways to minimize the impact that prior authorizations have on patient care, creating a better healthcare environment for healthcare professionals and their patients.

3. Improved Communication Cycles 

The six healthcare groups stated that better relations between care providers, patients and health plans are essential to improving prior authorization procedures. The requirements of authorization processes can be more easily understood by everyone involved if there is an ongoing dialogue between each group.

4. Prior Authorization Automation 

The groups’ letter proposed an increased use of electronic systems in order to improve medical authorizations. Technology such as that used by Rev-Ignition allows healthcare organizations to create a more efficient authorization process and minimize errors for the benefit of all parties. As long as a technological program meets national standards, it could be an industry-wide solution to helping patients and their care providers across the country.

5. More Focused Authorization 

The statement suggested that the healthcare system should adopt a more careful approach to prior authorization. It advised that authorization should be based only on provider performance and compliance with evidenced-based medicine and various contractual agreements. This could enhance the quality of care provided by healthcare professionals while decreasing the time spent on authorizations – both of which could improve patient care and outcomes.

Prior authorizations require an extreme amount of resources and time. As a result, they can leave healthcare workers feeling drained. Perhaps even more importantly, care providers are often stalled on handling patient care needs due to administrative tie-ups. If the health system adopts some or all of the changes suggested above, patients could realize better health and medical professionals could find greater satisfaction in the workplace. Rev-Ignition understands how complicated medical billing processes are, and we want to help your physical therapy practice benefit from our services. We can help you with prior authorization or revenue cycle management tasks. As a result, your organization can improve its processes and have a more stable financial future. Need a consultation for you practice? Email us at sales@rev-ignition.com