The prior authorization process is often time-consuming and cumbersome, requiring hours of preparing forms to submit to payers for approvals. This can result in delays in care, or even denial of much needed treatments.
Some of the challenges administrative staff faces include:
- Time-consuming: The process can take days to research and complete.
- Cumbersome: There is often a lot of paperwork involved which may need to be faxed.
- Can result in delays: Delays in care can occur if the requests are not completed in a timely manner.
- Can be denied: Coverage for treatments can be denied if the prior authorization requirements for care delivered is not met.
Our online clinical guidelines search tool helps staff overcome such challenges by reducing time to review commercial payer requirements when preparing prior authorization submissions.