Preauthorization Hell, WCH Can Help!
- Have all information in place: referrals, letters of medical necessity from referring providers, prior tests results,
- Have a protocol in place: the date when prior approval request was submitted, reference numbers, document control numbers, proofs of submission, name of the representative you spoke with, etc., all must be properly noted and stored.
- Use web portals to obtain prior authorizations, it is faster and more cost-saving.
- Call in case the patients is in pain, it’s easier to obtain authorization with the patient presence in the office
- Establish a follow-up process and log call recording for each authorization request
- Ordering physician should be on the call when speaking with insurance to clarify clinical findings
- Referrals are easier approved by payers if they are made within the participating provider network.
- Make an effective appeal. If payer issues a denial, confirm payer’s appeals guidelines and submit all necessary documentation to support the appeal.
If your practice needs guidance with the authorization process , WCH can help!