PRIOR AUTHORIZATION IS PRIORITY

29 May, 2019 Healthcare services
IMG

What is it prior authorization? Whether we should get authorization from higher officials? But, for what purpose we should take it. For whom we should pursue it? Is it necessary? Is it related to medical billing? Throw away all your chaos. Here, comes an answer to all your questions and doubts.

WHAT IS PRIOR AUTHORIZATION?

Prior authorization is nothing but an official confirmation obtained by the physician from the concern health indemnity plans. Everyone does not intake the same kind of medicine and need the same one. In this scenario, we should take proper care of our health and medications possessed by us. To reduce our workload and pay attention to our health, we should select a good and best healthcare services. They will focus on our dos and dont’s of our medications and gain the revenue of medical practitioners.

WHAT IS THE PROCESS IN PREAUTHORIZATION?

The above flowchart shows the steps done in the preauthorization process. There are five major steps in pursuing authorization from the insurance company.

Physicians review the reports

Yes. The physicians will monitor and review whether you certainly need these medications and clarify it with your concern family doctor or medical practitioner.

Check PA requirements

Verify the prior authorization requirements for the patients. Interpret it with the health plans and norms, whether it suits the concern plans and claims.

• Drugs are preventive or not
• Whether used for healthy persons or life-threatening patients
• Drugs that are included by your insurance company and uncovered medicines that are essential to you
• Drugs prescribed for certain age groups
• Drugs that are toxic to you.

Contact healthcare service

Contact and discuss with the healthcare service company for the authorization.

Clean approval from the insurance company

It will take approximately ten days to check your authorization request keenly.

Precede the plans further

After the confirmation from the healthcare service, your indemnity claims can be processed to attain the medical billing amount from the concerned company.

WHY WE SHOULD DO IT?

It’s an easy procedure for minimizing the costs of the medicines. In this high-rising and the affluent world, all the things are very expensive, even a pen and pencil. So, we should earn more reversely we should save more. By this concept, we should get only the medicines which will promote your health condition. Unnecessary medicines will lead to risk.

Is this associated with healthcare service?

Yes, of course. It’s related and connected with the healthcare services and this process helps you to obtain permission from your concerned physicians quickly. It mainly changes the life track of the diseased people to a healthy person.

Does it elevate the process of medical claims?

Absolutely, yes. It’s the first and foremost process in leading you to attain the medical bills soon. Actually, after passing via this process, your indemnity claims are accepted by the healthcare service. If you failed to do this process, then, your indemnity claims will collapse. To finish this process, certain healthcare services put great effort like checking the health plans with you and your medical practitioners, endeavouring to pass on the claims quickly and reducing the rate of rejection claims.