Prior Authorization Services: The Saving Grace

Prior Authorization Services have come out as respites for the medical service providers just when they fear to hit the low due to the decision was taken to end the ACA subsidy.

Confusion and uncertainty are looming large over the healthcare industry sky with the decision to end ACA subsidy payments have raised a storm and everyone is waiting anxiously to see what kind of health insurance impacts come to the consumers as enrollments for 2018 begins in shortly. The implementation may have a devastating effect on the patient and providers as well. Probably, the care givers will have more impact, the negative ones on their business. Prior authorizations in particular have become the greatest area of worry for the fear of rising prices of medical services and equipments, and increased premiums charged by the insurers. There’s a getaway from this but first, let see what and how this calling off would affect the industry?

The Roll Backs

The decision rolls back ObamaCare's expansion of Medicaid for the poor. This directly affects 17.6 million people in the United States who gained medical insurance coverage as a result of ObamaCare. ObamaCare also eliminated insurance companies' policy of excluding those with pre-existing conditions and had kept children on their parents' insurance until the age of 26. These will also be going to be called off.

Hit on Hospitals

The rollbacks of the subsidies have the following repercussions on the account books of hospitals and medical providers:

• The out of coverage patients will go to the hospital emergency care for treatment and hospitals will face the risks of short-payment from these patients.

 

• Insurance companies will end up losing revenues as they have to increase the premiums due to lesser number of people covered and as a result, limited people will sign with them. So, less people undercover is again, less patients going for moderate to high-cost treatments, medications, and procedures.

Prior Authorization Services to the Rescue

When it comes to the hospitals, labs, imaging centers, physicians, healthcare centers, etc. prior authorizations become a pain for them in this scenario. It’s very evident for the reasons cited above that how medical insurance and prior authorization being a very prominent part of the process will get affected. Prior authorizations are going to be more complex and the in-house staff of the facilities will feel the growing burden of complexity and the increased ratio of denials and rejections.

To combat this situation, expert prior authorization services aided with fast and efficient online prior authorization software come as huge reliefs for the medical providers and healthcare centers.  Top and reliable prior authorization services of the country have quickly measured the situation and have been acting as guides and situation handlers for their clients. One of such prior authorization services PriorAuth ONLINE, assures its clients an instant reduction of 80% in their costs. Ranked among one of the best prior authorization services, PriorAuth ONLINE is the online prior authorization platform of Sun Knowledge Inc. A base price of only $5 per auth and an efficiency rate with 99.9% accuracy makes PriorAuth ONLINE stand out among its competitors. Excellent references with over 100s of clients is indeed a proof of its reliability. Additionally, PriorAuth Online is rare among the prior authorization services to work with both payers and providers. It has dedicated managers with expertise in prior authorization requests. So, all is not lost, online prior authorization services, especially the likes of PriorAuth ONLINE keeps the flame burning for the healthcare providers in this unsettled time. 

Author's Note

The author of this article writes various blogs and articles on prior authorization for healthcare industry e.g. expert prior authorization services etc.