Almost 68% of physicians reported that it is challenging to find whether a prescription medication needs prior authorization. Also, 58% reported that it is challenging whether a service needs prior authorization. A major chunk of physicians and a whopping 87% reported that continuity of care is interfered with faulty prior authorization process. It is true that roadblocks with prior...

Accounts receivable services includes management of any report that deals with insurance, write offs, analysis of collections as well as ratio analysis. Also, it includes detailed analysis of the insurance contracts ensuring that the providers of healthcare services are getting correctly reimbursed. The longer the time span of AR going unpaid, it is less likely the healthcare providers will be...

Overview Prior authorization (PA) is a common practice in healthcare today. In recent years, there has been a growing trend in outsourcing it to dedicated, third-party specialists. But how good has been the outcome? So the question of the hour is, should you outsource PA in 2022? PA is a process where insurance companies approve or deny claims before they pay out benefits. This process helps...

It is true that high costs of drugs and also slim margins have characterized the home infusion pharmacy industry. If you are looking to maximize the profits, you need an expert team of efficient, highly trained and expert billing and collections workflow that should be in place. A quality outsourcing firm that specializes in extending home infusion billing has all the trained staff that can...

It is no denying that getting prior authorization involves many patients who are primarily health insurance companies, patients and the healthcare professionals. When it comes to any medication prior authorization, the process starts with a prescriber ordering a medication for its patient. After it is received by the pharmacy, the pharmacist must be made aware of the prior authorization status...

In the last 1 year, 96% of healthcare providers ended up hiring temporary professionals to combat the shortage of healthcare workers. Today staffing shortage continuous to plague healthcare practices.  Making it harder for healthcare providers, to manage a seamless billing operation is now a challenge.  According to the Bureau of Labor Statistics, hospitals are in fact down by 76% of...

It is true that not only resources are becoming difficult to bring on board in 2022 but the cost of employee turnover is huge and increased expectations of salary are busting budgets across industries. Hourly pay rates, overtime, and other associated costs of hiring more are creating huge challenges for DME providers at large.  Digital automation is the need of the hour to eliminate any...

The process of prior authorization was initially introduced to give patients the right care at the right time within a cost effective method that has now become one of the challenging aspect.  And moreover, with the changing authorization regulations, dilemma among the cost conscious insurance companies, patients other healthcare staff; the situation is even further complicated and will...

DME Prior authorization (PA) was introduced in the United States' healthcare system to improve patient safety and reduce wasteful expenses by implementing evidence-based care best practices. The DME Prior authorizations process is handled in a variety of ways based on the policies, methods, tools, and capacities of those involved. It typically involves communication and coordination among:...

DME Prior authorization is typically required by health insurance companies for pharmaceuticals, durable medical equipment (DME), and medical services. Insurance authorization services are offered to assist with the administrative load involved with the procedure. The American Medical Association (AMA) cautions, however, that DME prior authorization regulations are riddled with issues....