Prior authorization is one of the most exhausting and difficult components in the entire revenue cycle. It can interrupt workflows, tie down in-house resources, and cause severe disruptions to the medical billing process. It is also a time-consuming process that can take away precious hours from your schedules. Prior authorization issues are associated with 92 percent of care delays and may also contribute to patient safety concerns as well as administrative inefficiencies.
Considering the current scenario, Prior authorization is overused and the existing processes are too difficult. Due to its widespread usage and the significant administrative and clinical concerns it can present, prior authorization is a challenge that needs to be addressed through a multifaceted approach to reduce burdens on physicians and patients.
The inefficiency and lack of transparency associated with prior authorization cost physician practices time and money. The lengthy processes may also have negative consequences for patient outcomes when treatment is delayed. In the current managed care environment, an increasing number of prescriptions are being denied by plans, requiring prescribers to complete prior authorizations. This process is highly disruptive, time consuming, and often leads to denial without any relevant clinical review.
