According to GAO (Government Accountability Office) Report, CMS’s prior authorization programs for mobility devices and durable medical equipment (DME) created $1.1 and $1.9 billion from 2012 to 2017 in Medicare saving by controlling unnecessary spending. Providers in this prior authorization program gave a positive response as the process of prior authorization ensured a complete reimbursement for DME services. In fact, a study has shown that when CMS had implemented the prior authorization programs for DME, non-emergency oxygen therapy, Durable Medical Equipment, Prosthetics Orthotics & Supplies (DMEPOS) and home health care services GAO experienced some states had a decrease in DME expenditure. In fact without prior authorization process, the total DME expenditure would have increased by $2.1 billion.Add paragraph text here.
The reason for prior authorization is to reduce improper payments, lessen expenditure and unnecessary utilization. The process of prior authorization gave the providers an understanding of which service and device need additional documents support. In fact, providers have even reported GAO, that the process of prior authorization discourages healthcare fraud which is why providers wanted CMS to expend the prior authorization programs. Though GAO during the prior authorization process have noticed providers experience administrative burden for the prior authorization process. As the prior authorization process requires lots of patience and skilled resources which is why outsourcing is the best option for providers.Add paragraph text here.
What makes outsourcing better?
In outsourcing dedicated resources are available specifically for your account. Prior authorization requires a lot of follow up where an in-house staffs can’t provide, as they are often seen juggling between the front desk and prior authorization work thus delaying the process of prior authorization. So choosing the right operational extension becomes very vital.
Sunknowledge service Inc a decades-old 360 medical billing organization has specialized prior authorization section “PriorAuth Online’. With a track record of 99.9% accuracy, 80% instant cost reduction and working with more than 100 clients including Medtronic Sunknowledge has created a place of its own in the health care industry. A 100% Prior authorization submission on the same day and an increase in your current rate of prior authorization by 1.5-2x are what Sunknowledge provides.
If you facing problems related to DME prior authorization call Sunknowledge expert and get effective solution and streamline operation with increased cash for your organization. For more information get in touch with our experts, we are just a call away!
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