Today there are many options for a healthcare provider to choose an orthotics and prosthetics prior authorization solution. However, the main problem that the healthcare faces is choosing the right operational extension that perfectly suits your organizational requirements.

Resolve your Orthotics and Prosthetics Prior Authorization Problem with Sunknowledge help

Sunknowledge Service Inc a 100% HIPAA and HITECH compliance organization perfectly fit in such case. As being a decade old 360-degree successful practice management/revenue cycle management organization, we do not work with the concept of one fit solution for all. In fact, our pool of resources provides customized reporting according to clients protocol (daily/weekly/monthly) with 24*7 dedicate an account manager.

In fact, with years of experience, we also specialized in prior authorization process ‘PriorAuth Online’. our PriorAuth Online provides complete operational transparency with guarantee 100% prior authorization submission on the same day with a 1.5-2x increase rate. In fact, partnering with us will also help you achieve an instant 70% operational cost reduction, 30% shrink in your AR bucket and also 97% highest first pass collection rate. Our 99.9% accuracy rate with the highest productive metric help us earned excellent industries reference with more than 100 clientele.

The Steps are Expert Follows for Orthotics and Prosthetics Prior Authorization:

The prior authorization first step starts with collection of information for the following:

• Name, date of birth, insurance details of Patient/subscriber
• Servicing provider information details (LAB)
• Ordering provider information details
• Place of Service
• Procedure / CPT codes
• Diagnosis codes
• The estimated date range for Pre-authorization

This is followed by contacting the payer and payer related activity

• Determine the process for prior authorization request submission, i.e. portal, fax, phone, etc.
• Contact for UM/Pre-Authorization department
• Fax to send medical notes
• Expected turn-around time
• Limitations/exceptions (if any)

The third step, which includes predetermination, initiation and follow up activities

• Check to determine whether patient is eligible based on payers requirement for PA
• Initiate prior authorization as per payers’ guideline/protocol
• Follow-up with payer to check authorization status via outbound calls, portal etc
• Follow-up with ordering physicians’ offices for medical notes, documents and therapy chart if required
• Providing additional documents/information if requested by the payer

The last step involves the update of Authorization outcome in the PM/billing system, which requires information of

• Authorization
• Date range
• Units

As being the largest service provider in the prior authorization process, we are the only RCM organization providing pre-billing activities too. This includes right from order entry, eligibility verification and authorization (Online/ calling), authorization initiation and follow-up, collection of needed documents. Even doctor’s office follow-up, order confirmation and scheduling of delivery are also done by us under pre-billing activity. So with a no binding contract and a standalone /end to end service easing your orthotics and prosthetics prior authorization problem we are definitely worth a try.  So call our expert and get effective revenue generation solution at a service charge as low as $7 per hour. We are just a call away!