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We Take the Struggle Out of Prior Authorizations
Imagine spending half an hour on each prior authorization with a busy practice that quickly adds up. It's like spending an entire day just trying to get approvals. And what about your patients? Delays in care can be frustrating for everyone involved.
Tackling this dilemma requires a strategic approach. You need a solution to handle the volume, streamline the process, and ensure accurate and timely approvals. That's where our service comes in.
Our service is your lifeline. We’ll rescue your practice from the administrative chaos and ensure your patients get the care they need without delay. Don’t hesitate; make a wise choice for your patient’s well-being.
Is Your Practice Stalled by Prior Authorization Bottlenecks?
Slow Turnaround Time
Long wait times for payer responses
Complex Payer Policies
Difficult-to-understand guidelines
Multiple Payers
Dealing with various insurance plans
Unclear Medical Necessity
Difficulty justifying treatments or medications manually
Lack Evidence-Based Support
Insufficient data to support requested services
Experimental or Off-Label Use
Requests for unapproved treatments or medications
System Errors or Glitches
Issues with online portals or electronic submissions
Outdated or Incompatible Software
Difficulty integrating systems with EHRs
Our Step-by-Step Prior Authorization Process
Our step-by-step approach leaves no stone unturned, guaranteeing timely approvals and uninterrupted patient care.
Our Step-by-Step Prior Authorization Process
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Physician orders a service that requires prior authorization.
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The system captures the request and initiates the authorization process.
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The system determines if prior authorization is necessary based on CPT codes and payer policies.
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If allowed, the system submits the authorization request electronically to the payer.
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If electronic submission is not possible, the system prepares and submits the request manually.
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The system tracks the status of the request and initiates follow-up actions if needed.
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The system provides real-time updates to the physician and patient.
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If the authorization is approved, the system records the approval and updates the patient's chart in denial case the system rectifies issues and auth is resent
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The system generates reports on authorization trends and performance metrics.
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Historical data is used to inform future strategies and improve the authorization process.
See How Much You Can Save By Outsourcing Prior Auth
Hours Spent In-House Auth
- 40hrs / week
- You spend $600 / Week on billing resources
- HMS Costs $250 / Week
- You Save 350$ / Week
Average Hourly Rate of Resource
- $15 / hr
- $15 / hr
- Average resource costs $6/hr
- $1400/Month
Users
- 2
- 2
- 2
- $16,800 / Year
Why Outstaff Your Authorization Services To HMS USA LLC?
Faster approvals mean quicker patient care, and less time wasted on paperwork. Imagine what you could do with all that extra time back.
Slash Approval Times
Let’s face it—prior authorizations are a headache. That’s why our team of dedicated experts handles everything for you. From start to finish, they manage the complexities of prior auths.
Dedicated Prior Auth Specialists
Denied authorizations slow you down and cost you money. With our proactive pre-auth checks, we prevent up to 50% of denials before they happen.
50% Reduction in Denials with Pre Auth
Our on-demand scalability means you get extra support during those busy months, ensuring your patient care never misses a beat, even during peak periods.
Scalability to Handle High Volume Periods
