Prior Authorization - Some Updates and Quick Questions
May 31, 2018
Healthcare
Prior authorization has been designed as an instrument to minimize healthcare costs and control price-rise of medicines and medical equipment, wherein a pre-approval is required by the insurance company to pay its beneficiary for any medical service that they intend to avail. Prior authorization has recently seen a minor overhaul with several regulatory and policy change implementations. Prior authorization is under rapid transformation from the manual mode to the electronic platform. This change of process has brought some complexity around prior authorizations needing adherence to stringent guidelines and additional documentation. Prior authorization has become indeed become tougher and rejections are quite a regular affair. In this scenario, much of the onus is on the professional prior authorization services who are well equipped with latest prior auth updates, knowledge of latest EHR and EMR technologies, coding expertise, etc. Although a huge number of healthcare providers s...