A better way to manage prior authorizations
Prior authorizations remain one of the least automated types of healthcare transactions—and one of the biggest industry pain points. Studies confirm that managing prior authorizations manually in-house delays patient care, burdens internal resources, and decreases patient satisfaction. Balancing the need to secure authorizations with the costs of dedicating significant staff time—waiting and following up via phone, fax, and email—is no easy task.
What if your staff could focus on patient care while a dedicated and experienced team works prior authorizations behind the scenes?
Availity’s Authorization Services offers a better way to manage the authorization process, freeing up staff to work on more high-value activities and helping your organization operate at peak capacity. Getting answers efficiently also helps improve patient satisfaction and facilitates timely scheduling.
How an Authorization Service Works
A dedicated Availity team remotely monitors incoming referrals, determines which requires a prior authorization based on payer and RBM rules, and submits clinical documentation on your behalf. Once the authorization is obtained, Availity documents the response and updates your EMR with the status.
Your staff can monitor the progress of authorizations within the EMR and schedule procedures accordingly. Additionally, you can track progress with detailed reporting, working with Availity to refine processes and align with goals. This service is fully HIPAA compliant, secure, and reliable. See how it works for Spectrum Therapy Consultants
A Referring network model
Availity Authorization Services can also create a closed-loop network for hospitals or imaging centers and their referring clinics to collaborate on prior authorizations. In this model, an Availity team remotely monitors orders entered by referring physicians into our AuthPal product. The team determines which cases require a prior authorization based on phone calls to payers and payer/RBM rules, and if an authorization is required, submits the authorization along with clinical documentation on your behalf.
Once the authorization is obtained, Availity documents the response and updates AuthPal with the status. Your staff can monitor the progress of authorizations within AuthPal and schedule procedures accordingly. See how it works for Premier Diagnostic Imaging
Benefits at a glance
No matter what your specialty, Availity Authorizations Services delivers consistent results and helps you achieve the following benefits:
- Obtain timely and accurate prior authorizations
- Streamline scheduling and improve patient satisfaction
- Increase referrals
- Reduce denials AND increase collections
- Reduce costs