Running a medical practice comes with an abundance of responsibilities. One of the most crucial aspects of patient care is insurance authorization. Medical practices must obtain prior payer approval for certain treatments, prescriptions, or tests for the patients they serve. Insurance authorization is critical to streamline the medical billing process and ensure that medical practices receive fair compensation for services rendered.

However, the process of obtaining prior authorization can be time-consuming, challenging, and frustrating for medical practices. We understand how difficult it can be to navigate the complex system of medical insurance authorization. In this blog, we’ve compiled essential efficiency tips for medical practice managers to help them simplify the insurance authorization process. By following these tips, you can minimize denials, save time, and improve the overall patient experience.

#1 Master list of procedures

Maintaining a comprehensive master list of the procedures and services that require authorization is essential. This list should be readily available to all staff, and periodic updates should be made to ensure that it’s always current.

#2 Document denial reasons

Thorough documentation of all denied authorizations is crucial to eliminate repetitive denials. By documenting the reasons for the denial, medical practices can avoid repeating mistakes or submitting insufficient information in the future.

#3 Stay informed

Regularly updating oneself about changes in the medical insurance industry can help medical practices stay ahead of the curve. It’s important to stay informed of changes in authorization requirements and adjust practices accordingly. Staying informed of industry standards can also help medical practices offer better patient care.

#4 Inform scheduling staff about procedures that require prior insurance authorizations

It’s vital to inform scheduling staff of the procedures that require prior authorizations. When the need for pre-authorization is known in advance, scheduling staff can initiate the process in a timely fashion, which saves time for all involved.

#5 Embrace technology

The medical billing process involves the use of multiple software programs and technologies. Staying current with the latest technologies that can simplify the authorization process is essential. Establishing secure electronic communication channels with payers can expedite the approval process and reduce the overall waiting time.

#6 Thoroughly document clinical data

Medical practices should maintain and regularly update patient profiles and documentation. Complete documentation will make obtaining authorization for different procedures or tests easier. It’s imperative that medical practices maintain the highest standards of complete and accurate documentation.

#7 Record all correspondence

All correspondence with payers should be recorded to create a paper trail. This record of contact ensures that all parties are on the same page in the authorization process, and it can help resolve disputes much more effectively.

#8 Create a follow-up plan

Having a clear follow-up plan with staff is important. Periodic follow-up reminders should be sent to staff to ensure the continued progress of the insurance authorization process.

#9 Be methodical

The insurance authorization process can be challenging, but it’s crucial to remain methodical throughout. Medical practices should establish a standardized process that ensures that each required step in the authorization process is followed consistently.

#10 Outsource if necessary 

In a recent poll by Azalea Health they asked what was the biggest challenge concerning prior authorizations. 32% of participants answered “administrative burden”. Sometimes, outsourcing insurance authorization tasks to a professional company, such as MedCall Plus, can be a wise decision. MedCall Plus is a patient support service that specializes in managing administrative tasks, including insurance authorization. The team is well-trained, experienced, and committed to ensuring a smooth and efficient authorization process. By delegating these complex tasks to a trusted partner, medical practices can free up their internal resources to focus more on patient care and less on administrative burdens.

In conclusion, insurance authorization can be a frustrating and time-consuming task for medical practices. These efficiency tips will help you streamline the medical billing process, minimize denials, save time, and ultimately improve patient care. With thorough documentation, comprehensive lists of procedures that require authorization, and an informed and organized approach, medical practices can reduce the stress and workload associated with insurance authorization. We hope that by implementing these tips, you will establish a more efficient and successful medical practice. 

In addition to implementing these efficiency tips, consider reaching out to MedCall Plus for personalized consulting services tailored to your medical practice’s specific needs, further enhancing your authorization process and overall operational efficiency. Learn more about MedCall Plus here.