PROVIDER PRIOR AUTHORIZATION
When the process is automated and real-time, prior authorization can reduce post-service denials, re-submissions, medical reviews, physician and clinical staff time, and patient rescheduling, and in turn improve patient satisfaction scores. Prior authorization is the closest assurance providers receive from payers guaranteeing payment for treatment.
The lack of automation and real-time responses causes delays in approvals, higher rate of denials, requires administrative and clinical FTEs, and delays patient treatment and outcomes. IIC’s automated EDI 278 prior authorization solution simplifies administrative processing, reduces delays, increases utilization rates, and provides a uniform workflow when submitting authorization requests to payers.