Consolidations, shrinking revenues, and labor shortages require healthcare providers to do more with less.
It’s no secret that prior authorizations cause headaches for most healthcare providers–88% describe the burden associated with prior authorizations high or extremely high.
Not only have these cumbersome practices delayed patient care, but they’ve also taken an administrative toll on physicians, hospitals, and staff. According to the 2021 AMA Prior Authorization Survey, physicians and staff spend an average of 2 business days completing prior authorizations.
This is largely due to the lack of standardization, transparency, and automation across health plans and modalities.
With the nationwide labor shortage, providers can’t afford to lose valuable team members who perform prior authorizations.
Here are three ways for providers to protect their prior authorization from turnover:
Centralize and standardize operations
Where possible, providers should centralize their prior authorization operations–it sets your team up for collaboration, knowledge-sharing, and professional development opportunities.
At Advantum Health, our best learning happens when our leaders huddle with their teams to solve problems. Whether we’re meeting in person or remotely, centralizing makes this possible.
It’s easier and quicker to identify, train, and communicate ever-changing payor rules, especially with prior authorizations.
Once centralized, you’ll have a foundation to evaluate your processes and identify best practices.
It won’t be easy and standardizing will initially disrupt your operations. Any change is hard. But, when done right, prior authorization standardization will boost employee morale.
Remove the guesswork with automation.
When it comes to streamlining your prior authorization process, automation is key.
To maximize automation benefits, find a reputable vendor with the capability to set up electronic submissions with all of your applicable payors.
Then, once you’ve established your electronic prior authorizations (PA) approach, it’s imperative to integrate them with your EHR so they are workflow-based.
Make it a goal to automate workload prioritization and required documentation. These can vary based on services, health plans, and department needs. When you eliminate or reduce the touches required to complete an authorization, you lower your margin for error.
Not only will this reduce redundant work, but it gives your team confidence that they’ve met all the prior authorization requirements.
Get outside help.
Whether requesting approval for medical equipment or for a brand-name drug, the prior authorization submission process can waste hours of time.
Even with automation, many providers find the new processes, technology, and change management too much to manage. For those physicians, hiring a third-party vendor makes sense.
Prior Authorization vendors often have the infrastructure already in place that would take a provider years to implement. This enables physicians to do what they do best: take care of patients.
Keep in mind that not all vendors are equal. It’s important to find a dependable and reputable vendor who matches the culture of your organization.
Conclusion
Healthcare advocacy groups keep pressuring Congress to pass legislation that will remove insurance prior authorization roadblocks. But, it will take time for physicians and patients to reap the full benefits.
Right now, we’re in the midst of a national healthcare shortage, and depending on your geographic location, it could get even worse.
Streamlining prior authorizations through standardization, centralization, and automation will help providers to remove administrative obstacles and improve processes so they can minimize turnover while maximizing healthcare outcomes.
Want to learn more about streamlining your Prior Authorizations? Advantum Health can help.