Healthcare organizations spend up to $31 billion annually interacting with health insurance companies about authorizations and payments. For most providers, it’s still a manual process. Outsourcing saves time, reduces denials and increases revenue.

1. 5 Good Reasons to Outsource
Your Authorizations
UP TO $31 BILLION
That’s how much healthcare organizations spend every year interacting with health
insurance companies regarding payments and authorizations. Plus, upward of 90%
of providers still process authorizations manually.
Up to 36%
of denials are due to insufficient authorizations
and patient registration issues
Lack of authorizations is
the leading patient access
related denial
$14.07
Average provider cost to manually
process an authorization
$45.49
WITH ATTACHMENTS,
manual authorizations
nearly triple in cost
2. TRANSACTION COSTS
63%of providers
wait several days to receive
appropriate authorization
13.1 nurse staffing
hours/week spent per
physician on authorizations
3. WASTED CLINICAL STAFF TIME
4. LOST PATIENT VOLUME
46%
Why? • Referrals not properly authorized
• Long lag time to schedule patient
5. CREATE COMPETITIVE ADVANTAGE INSTEAD
Only 6.7% EDI
A fraction of authorizations processed
via EDI in 2014. Most providers are still
burdened with manual workflows.
OUTSOURCE FOR FAST AUTHORIZATIONS
American Medical Association – May 2010 Study of 2,400 Physicians
NAHAM, The Future of Patient Access, 2010
Milbank Quarterly, Dropping the Baton: Specialty Referrals in the U.S., 2011
Journal of General Internal Medicine, 2009
Heath Affairs, What Does it Cost Practices to Interact with Health
Insurance Plans, 2013
1. DENIALS
PCP
PCP
PCP
By outsourcing to a vendor specializing in authorization workflows, providers can
reduce denials, accelerate scheduling, lower costs, provide a better patient
access experience – and stand out in their market.
The 2014 Council for Affordable Quality Healthcare (CAQH) Index
2014 Physician Referral Survey
2013 Physician Inpatient/Outpatient Revenue Survey
Healthcare Financial Management Association - HFMA.org
Journal of General Internal Medicine
SCI Solutions empowers communities by virtually integrating
business processes across provider networks to coordinate
patient care and improve outcomes. scisolutions.com
Sources:
of faxed referrals never result
in a patient visit