Outsourcing Prior Authorization

Outsourced Prior Authorization Specialists are tasked with functions that encompass submitting preauthorization requests to multiple insurance companies and diligently following up on them.

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Outsource Prior Authorization with CyPrep

Companies have the option to delegate the Pre-authorization process, also known as Prior Approvals, which plays a crucial role in the revenue cycle management.

Outsourced Prior Authorization Specialists handle various tasks, including the submission and diligent follow-up of preauthorization requests with multiple insurance companies. They perform authorization checks, such as verifying whether the authorization process began online by accessing the database. They also conduct verifications through phone calls, faxes, clinical assessments, history of present illness (HPI) evaluations, and physician peer-to-peer consultations. Additionally, they assess and request any additional documentation required for the authorization process.

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Benefits of Outsourcing Prior Authorization

The time and effort that front desk and in-house healthcare staff invest in administrative tasks, such as waiting for responses to eligibility inquiries or pre-authorizations, can be entrusted to a dedicated offshore healthcare team.

By delegating responsibilities like dispatching authorization requests, generating authorizations, and monitoring the expiry of specialty infusion authorizations and prescriptions within the specialty departments, the pre-authorization process becomes more streamlined. This ensures that other specialty care plans are processed with the required authorizations, and claims are handled accurately.

Outsourcing prior authorization enables healthcare providers to refocus their attention on delivering exceptional patient care. The reduction in administrative burdens allows staff members to concentrate on cultivating meaningful patient relationships, enhancing the overall patient experience, and providing prompt treatments.

Implementing efficient pre-authorization procedures results in shorter wait times for patients, fewer appointment rescheduling occurrences, and improved accessibility to essential treatments. These factors collectively contribute to elevated levels of patient satisfaction.

  • Outsourcing pre-authorization allows healthcare providers to recapture precious time and resources that were formerly dedicated to the labor-intensive process of overseeing prior approvals. By collaborating with specialized outsourcing firms, providers can entrust the task of securing pre-authorizations to seasoned experts. This empowers internal staff to concentrate on fundamental responsibilities like patient care and revenue generation, resulting in a substantial enhancement of overall operational efficiency.

  • Entrusting pre-authorization to specialized service providers guarantees access to a team of seasoned experts with a profound understanding of insurance protocols and prerequisites. These professionals remain well-informed about the most recent industry developments and regulatory alterations, thereby diminishing errors and heightening the prospects of successful claim submissions. Consequently, healthcare organizations can uphold compliance standards, diminish claim denials, and expedite the reimbursement process.

  • Outsourcing pre-authorization enables providers to streamline the approval process, leading to quicker claims submissions and diminished reimbursement delays. Teaming up with seasoned outsourcing companies grants healthcare organizations access to their advanced technological infrastructure, automated workflows, and finely tuned processes.

  • Conducting pre-authorization in-house entails substantial overhead costs, such as staffing, training, and investments in software. Outsourcing pre-authorization negates the necessity for these expenses, as providers can leverage the proficiency and infrastructure of external service providers.

How It Works

We assist real estate companies, mortgage lenders, title companies, developers, and a variety of other entities in establishing dedicated support teams.

Access

Comprehend your business requirements to enable us to construct a team that can accelerate your growth.

Recruit

Thoroughly screen, interview, and recommend candidates who match your precise qualifications.

Train

Assist you in training your team for peak performance.

Evaluate

Conduct quality audits, evaluations, and feedback loops to guarantee that your team consistently meets the established standards.

Execute

Complete oversight of your team's production, coupled with continuous management support and consulting from CyPrep.

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