Prior Authorization is a perfect way to manage medical billing and control overall costs. As the technology is improving, the traditional prior authorization has become electronic prior authorization (EPA)

Electronic prior authorization is a new concept for almost every individual living in this world. People who get to know this term really appreciate its work. 

This authorization is able to change lives and we should give it away to establish those claims. It will definitely be a life-changing experience for our healthcare and patients. But let’s first understand what this term actually means and how it works. 

What is Electronic Prior Authorization?

Electronic Prior Authorization (EPA) is the electronic communication of data between the prescriber, and payer to specify whether or not the PA consents. NCPDP has formulated technological criteria to help people benefit from this electronic transmission and enhance the promptness of the exchange of data.

Electronic prior authorization (EPA) intends to speed up the procedure by carrying prior authorization documents digitally rather than via phone or fax. Means you don’t have to follow the historical measures anymore!

EPA can be incorporated into EHR networks to allow providers to easily wish prior authorization within their hospital workflow.

Top 7 Benefits of Electronic Prior Authorization:

Transitioning to solely electronic permissions brings functional efficiencies, sharper backtracking periods, and an optimistic impact on patient care. This article scrutinizes precisely how electronic authorizations and mechanization can boost providers and patients likewise.

Center Payer Database:

One of the most prominent skepticisms for different survey respondents was being able to regulate the proportion and assortment of payer requirements. Several examination respondents said they’d accept an extensive treatment that will enable their faculty to keep a soundtrack of the shifting payer requirements.

Preliminary authorization database updates payer requirements in real-time. Staff can check what’s wanted without having to attend multiple payer websites and infuse data by hand. 

Users also sustain from an enlightened, exception-based workflow, which identifies whether complaints are pending, refuted, or ratified.

Prevent Denied Claims:

In a questionnaire, it is primarily noted that without prior authorization their revenue is not paid to ensure prior authorization is one of the extensively common reasons for refuted claims.

This may occur if the patient’s procedure has to start before the prolonged authorization process is finished, or because the authorization does not encompass all the personal aspects of a patient’s procedure.

Automation guarantees that all documentation and records are valid and detailed and are in place, so compliances can be ratified sooner. Automation also authorizes payers and providers to see the equivalent account data, thus curtailing the demand for lengthy negotiations about the importance of authorization.

Enhanced Operational Efficiency:

 In one survey a respondent answered that most insurance companies demand pre-authorization be completed beforehand of the services being provided to the patients. This wastes their valuable nursing time.

Minimizing the inefficiency is becoming increasingly crucial as the covid pandemic is going. Staffing scarcities, rising healthcare expenses, and varying patient numbers put tension on earnings. Automating prior authorizations can curtail the physical pressure on faculty, and deal with the monetary expenses related to wasted periods and resources.

 Providers can enhance these functional efficiencies by giving rise to prior authorization software concurrently with other computerized payment progression devices, to establish more collaborative and cost-effective organizational methods.

Faster Prior Authorization:

The American medical association has asserted that more than eight out of ten doctors have discovered patient supervision halted or canceled just because the authorization is taking way too much time.

The additional third report observed a severe unfavorable circumstance to occur because of a delinquent authorization. Automating prior authorizations assists to guarantee that patients don’t miss out on crucial care because of organizational impediments.

Staff can save an average of 16 minutes per transaction, enabling them to activate additional authorizations in a limited time and safeguard patients from the clinical outcomes of wasting time.

Better Customer Experience:

Simplified workflows allow providers to provide a steady clinical and monetary experience for patients. An automated prior authorization system that increases patient flow and minimizes faculty intake, allows the staff to free themselves up and assist patients with other issues, and that human guide to follow up.

Limited waits and errors mean patients are less liable to feel hindered because they can see their reports being refined rapidly and carefully. And when patients have certainty that their care will be encompassed, they can focus on pursuing their care plan, instead of worrying about how and when it will be funded.

Reduced Administrative Burden:

The authorization that is paper-based often results in taking a step back and checking for all the mistakes that can be made which leads to organizational work to be repeated and different walks to pharmacy and payers and different healthcare provider

The American Medical Association documented in 2017 that 75% of doctors explain the responsibility correlated with prior authorization is very high and 22% of medics noted that they or their staff consume more than 20 hours a week finalizing prior authorization recommendations.

With real-time e-prior authorization tools, healthcare providers can complete a prior authorization easily with questions and comeback choices for the applicable prior authorization request established on an assortment of the product and the patient’s insurance coverage.

HIPAA-Compliant:

The fax machine is a long-recognized HIPAA-compliant method of delivering protected health information (PHI). Therefore, many healthcare providers depend on this tool, even though other industries have discontinued it.

Submitting prior authorizations electronically using iAssist is as HIPAA compliant and secure as using a fax machine, and provides automation that drastically improves office efficiency.

Conclusion:

As this world is growing and is shifting to various technological advancements, it is time for healthcare systems to accept these amazing technological changes. These changes will help our healthcare system to a great beginning and will help our frontier heroes to get some less burden on their shoulders.

Learning these new technologies will help our healthcare system to improve and serve our people rightfully. They can provide them the best care which prevails for them hence returning their health to them in a greater way.