Prior Authorization
Suppose that your patient requires an MRI tomorrow, that is on Tuesday. The order comes in, the radiology appointment is made, and then the insurance company requests paperwork that was not discussed at check-in. So Tuesday is over, and your patients are calling your front desk twice a day, your employees aren't getting to the next patient, and they're on hold with a payer. That's what PRIOR AUTHORIZATION can look like without a system designed for speed and efficiency, and that is why we created the Prior Authorization service at SolBridge Solutions to help prevent this void.
All requests are treated as if there is a clock ticking, and there is. We don't send a generic packet of clinical notes, diagnosis codes, and supporting records that any insurer requires: we send what the insurer requires. Each of the steps of a referral to the cardiology service or an MRI, specialty medication, and surgery has its own rules, and we know those rules before we submit, not after we hit a snag and end up learning the hard way.
After a request is sent, we don't wait and wait for the good news. We monitor open items on an ongoing basis every day and will send them back to a payer if they request extra documentation or peer-to-peer review within hours rather than days. A delayed routine authorization appointment may result in the patient not showing up and losing the appointment, and the lost appointment will mean lost revenue that you won't be able to recover later. Some payers even require that you have a conversation with their medical reviewer before an approval is issued, which is where we step in, so your physicians can spend their time caring for patients, rather than paperwork.
We also discover what your specialty is. Your team doesn't need to convert generic information into your realm since we adjust our practices to you, and your pain management practice and your dermatology office have different payer rules. This translates to fewer rejected requests, fewer irate phone calls from patients in limbo, and a more reliable schedule.
Do not allow patients to wait longer for care they need due to prior authorization issues. Give us a call at 1-844-687-3700 or contact us from our contact page and see one designed to keep approvals from piling up.