Getting Real-Time Information for hospitals and health systems
Getting Real-Time Information

The high cost of manual authorizations

Getting a pre-authorization for medical procedures is one of the most time-consuming healthcare administrative processes. Despite the industry’s trend toward automation, 82 percent of pre-authorizations are still processed manually.

This inefficiency is costing you in more ways than you might realize. Here’s how:

Staff efficiency

Call the payer. Wait for a return call. Check the payer website. Re-enter data on multiple forms. The current authorization process used by most healthcare organizations is time-consuming, repetitive, and error-prone. An inefficient process not only increases your labor costs, but it increases the chance of errors, denials, and ultimately lost revenue.

Patient and provider satisfaction

In a consumer-driven healthcare market, patients are looking for cost and convenience. They want to schedule procedures as quickly as possible, rather than wait days for confirmation. If other providers in your area can schedule and confirm the procedure before you can, which provider do you think they will choose?

Denials

Failing to get a prior authorization is one of the leading causes of denied claims. But as health plans increasingly require prior authorizations, providers find it difficult to stay up-to-date on the revised guidelines. Sometimes, even the payer website doesn’t have the most current information. Wouldn’t you like to be able to trust the information you receive from the payer is accurate, and conveniently store that information should you need to reference it in the future?

Revenue

With shrinking reimbursement and tight margins, it’s more important than ever to operate at optimal capacity. A last-minute cancellation because of a missing or denied authorization not only means lost revenue for that procedure but now you have expensive equipment and highly paid clinical staff sitting idle. Getting pre-authorization confirmations more quickly allows your organization to keep your schedule current and minimize cancellations.

If you’re ready to leave behind the old, inefficient authorization processes that are costing you time, money, and patient satisfaction, Availity can help.