Prior authorization issues were regarded as one of the top reasons for claim denials and reimbursement delays. An AHA report has stated that 89% of medical practices have seen an uptick in claim denial rates over the last three years, with 51% saying that the increase has been significant. About 80% of the claims denied are either due to the fact that no prior authorization has been obtained or submitting incorrect prior authorization requests. Even though providers are taking significant measures to address prior authorization claim denials, carriers continue to increase the number of medical procedures and prescription medications that require prior authorization, leading to an uptick in claim denials.
Let us now explore some of the reasons for prior authorization claim denials due to predetermination issues
Best practices to be followed for preventing prior authorization claim denials
Prior authorization is a time consuming and tedious process that can lead to denial of claims. That is why it is a good idea to outsource this crucial task to experts in the field. Scribe4Me has a team of PA specialists who can handle all paperwork and quickly obtain prior authorization approvals from insurance carriers. Sounds interesting? Well, taking the help of a professional medical billing company can go a long way in reducing denials, maximizing reimbursements and most importantly improving patient care and satisfaction. To learn more email us at [email protected]
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