Tasks You Can Delegate to Sunknowledge’s Prior Authorization Services

Prior authorization requirements delay care for patients. They are a common administrative burden that every healthcare provider wants to escape.

After a physician prescribes a treatment, they are met with bureaucratic hurdles. These hurdles delay patient care.

Numerous industry reports suggest that prior auth requirements are frustrating, time-consuming, and costly for both physicians and their patients.

However, with our streamlined ***prior authorization services***, numerous healthcare providers have been able to reduce their operational costs and the time it takes to get authorization from payers.

This has been possible partly because of our unique experience of adjudicating claims for various payers like BCBS, Emblem, Fidelis, Anthem, Aetna, Health Net, Humana, L.A. Care, Cigna, United Healthcare, and so on. Another important contributor to our efficient prior authorization workflows is the expertise and cost-effectiveness of our prior authorization specialist.

These two unique features of our pre-authorization services coupled with our comprehensive case-specific SOPs help complete every problem scenario with ease.

Everyone understands that it is important to simplify the prior authorization process to overcome authorization delays. But how do you do that?

Our Prior Authorization services stand on a strong foundation of expertise and experience. This enables us to provide solutions that reduce delays, cut costs, and prevent physician burnout.

Tasks our Expert Prior Authorization Services Handle

1) Gathering Patient Information:

Our team collects all necessary patient details, ensuring a smooth authorization process.

2) Verifying Insurance Coverage:

We meticulously verify patients’ insurance coverage to prevent surprises down the line.

3) Completing Authorization Forms:

Say goodbye to paperwork headaches. Our specialists handle all authorization forms promptly and accurately.

4) Following Up with Payers:

No more waiting in limbo. We stay on top of authorization requests, following up with payers to expedite approvals.

5) Resolving Denials and Appeals:

We strictly follow a prior auth claim scrubbing process. This process helps us to ensure that medical necessity of the procedure has been established and that all documentation and related information are accurate. In case, an authorization request is denied, don’t fret. We will handle appeals swiftly and effectively, maximizing approval chances.

Accuracy and awareness of regulations and policies for different payers are very important to complete PA requests on time.

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Why Physicians Outsource to Our Prior Authorization Services

1) Experience:

Sunknowledge has been adjudicating claims for payers for the past 14 years and has over 18 years of experience in completing prior authorization requests for healthcare providers. Currently, our pre-authorization services help physicians across 38+ specialties all over the United States of America. From electronic prior authorizations to manual submissions or submissions using fax, we excel in all three.

2) Cost-Effectiveness:

Our services are designed to save healthcare providers money. Medical centers can get our pre-authorization services by onboarding our prior auth specialists. These experienced professionals take care of PA requests from start to finish and cost only $7 per hour per FTE. By outsourcing prior authorization tasks to us, you’ll cut administrative costs by up to 80% and boost operational efficiency significantly. Also, Sunknowledge’s outsourced PA specialists cost clients only $7 per hour compared to the minimum wage of US healthcare workers which cost providers $15 to $30 per hour.

3) Dedicated Resources:

Think of us as an extension of your team. Our specialists are assigned to only one healthcare provider. They work full-time and take on additional responsibilities as required. These resources also work in real-time from a remote location with the help of a secure online connection. Having the same person work for them, brings a level of standardization to PA operations for healthcare providers.

4) Organized workflows:

Healthcare providers benefit from our comprehensive and organized workflows. These resources have been developed from our rich industry experience in handling claims both for the payers and the providers. All the prior auth specialists assigned to our clients have access to these regularly updated SOPs and resources to help them complete complex prior auth scenarios accurately and get approval from insurers very quickly.

5) Compliance and Accuracy:

We are a fully HIPAA-compliant healthcare revenue cycle management company. All our revenue cycle professionals undergo HIPAA compliance training. We also give healthcare providers the flexibility to get audits done whenever they want.

Don’t let prior authorization requirements hold your practice back. Outsource these time-consuming admin tasks to Sunknowledge’s Prior Authorization Services and experience improved operational efficiency and cost reduction.

To learn more about prior authorization best practices that fuel the efficiency and accuracy of our ***prior authorization services***, or for more information about our references matching your specialty, please contact Sunknowlede now.