Automated Prior Authorizations: Understanding the Three Key Steps
8.02.2017 By Availity
Availity Access provides a glimpse into the people behind our products. It features commentary on challenges facing the healthcare industry and how Availity can help providers and health plans better share healthcare information.
The process for obtaining a prior authorization from a payer is one of the least automated—and most frustrating—healthcare administrative processes. Pre-certification staff spend a lot of time trying to contact the payer, and it can take several days before they finally receive confirmation. The good news is that new technology solutions are hitting the market. The bad news is that it’s not always easy to differentiate one solution from the other.
In our latest vlog series, Mohammed Ahmed, Availity’s Vice President of Authorizations Sales Enablement, provides insight into the key features and functions you should look for in an automated authorization solution. In our first episode, Mohammed discusses the three key processes that an automated solution needs to support:
- Determination: Does the procedure in question even require a prior authorization from the payer?
- Submission: How are prior authorizations submitted to the payer, and what happens if clinical input is required?
- Status: How is confirmation from the payer received?
Want to learn more about automated authorization solutions? Download our latest eBook, 9 Things to Consider when Evaluating an Automated Authorization Vendor.