Both the patients and physicians get frustrated with the complexities of prior authorization. It is the mother of all problems between the healthcare and health insurance systems. The problem starts with a provider looking to approach the health insurers to ensure that the procedure, medications require prior authorization.
- On an average, a healthcare practice and its staff need to wait for a considerable amount of time for a decision from the health plans. Nearly, 64% wait for at least one business day while 30% report of waiting for at least three business days.
- For the patients, that require the treatment, nearly 92% report on care delays. Also, 78% report that the tedious nature in the prior authorization process leads the procedure abandonment in most cases. Whopping 92% report that prior authorization has a negative influence on the patient clinical outcomes. Physician burden with prior authorization is quite complex as well. Nearly 86% report of an increasing burden over the past five years.
- Additional burden with prior authorization are many. Repetitive nature of the prior authorization process is something that has to be taken not off. Nearly 79% of the physicians are always asked to repeat PA’s for the prescription medications. Approximately two business days get spent by the physician/ staff each week to complete the prior authorization workload.
- The health system should be such that it benefits the patients. The dysfunctional nature of prior authorization ultimately pains the patient than most. The patient bears the brunt and often is challenged with cancellation of prescriptions/ medications.
With that, almost 869 million hours get consumed with PA interactions annually. Any healthcare practice has to find the right solution and an reliable operational extension that can help in performing better with care management best practices.
The Sunknowledge Story in Prior Authorization
It is true that over the last decade, Sunknowledge Services Inc has made a name for itself by working with both healthcare providers and payers with admirable distinction. Our team of practice management experts has the answer to all your prior authorization challenges.
We help in delivering you faster prior authorization solution by following an excellent back and forth mechanism of sharing of information. Our resources provide the perfect platform with initiating PA request, validating and collection of the important documents, contacting the insurance companies and updating the PA outcome in the billing system of the client. Know more from our experts on how we transform your revenue.