Revolutionizing
Prior Authorization
At GenConnect Healthcare, we’re on a mission to transform the Prior Authorization (PA) process from a roadblock into a catalyst for healthcare excellence. PA is not just a formality; it’s your gateway to optimizing revenue while delivering exceptional patient care.
The Power Of Prior Authorization:
- Decoding PA
Let’s begin by decoding Prior Authorization. According to the American Medical Association, it’s the process through which healthcare providers secure advance approval from health insurance plans before delivering specific procedures, services, devices, supplies, or medications to ensure coverage.
- Provider's Time Dilemma
Imagine providers spending an average of 20 hours a week navigating the prior authorization maze. It’s no wonder that mishandling this process can cost practices dearly in terms of revenue.
Why payers embrace
Prior Authorization
Medical Wisdom
Payers demand prior authorization to validate the medical necessity of the recommended treatment or service.
Treatment Efficacy
It’s about assessing the effectiveness of the initial treatment period and the need for continued care.
No Redundancy
In the era of multi-specialist consultations, PA ensures no redundancy in services when patients seek care from multiple sources.
Cost Efficiency
Payers look to Prior Authorization to ensure cost-effective care and prevent unnecessary expenditure.
Prior Authorization
Quality Care And
Financial Prudence
At GenConnect Healthcare, we see Prior Authorization as a tool for elevating the quality of care offered by physicians. It’s all about ensuring care is justified, secure, accessible, and cost-efficient. Importantly, the prior authorization process isn’t applicable during emergencies. In certain cases, providers can even seek retro-authorization post-care.
Insights from the American
Medical Association
A recent American Medical Association survey highlights the impact of Prior Authorization:
93% of physicians report treatment delays due to PA.
24% report instances where PA resulted in patient hospitalization.
82% note that PA can sometimes lead to patients abandoning necessary treatments.
2 in 5 physicians allocate dedicated staff exclusively for PA management.
These statistics underscore
How Prior Authorization Directly Influences
The Quality Of Care And A Practice's Financial Health.
An efficient Prior Authorization process translates to:
- Fewer claim denials
- Reduced write-offs
- Lower patient financial responsibility
- Decreased provider liability
- No need for additional resources to handle the process
