Prioritizing effective handling of insurance prior authorization enhances overall practice efficiency and patient satisfaction.

1. Tips to Handle
Prior Authorizations
Effectively
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Tips to Handle Prior Authorizations Effectively
Prioritizing effective handling of insurance prior authorization enhances overall
practice efficiency and patient satisfaction.
Getting advance approval from a health plan before a specific service is delivered
to the patient is a time-consuming and often burdensome process. Dealing with
insurance prior authorizations effectively can improve patient outcomes by
ensuring that they receive the most appropriate medications, while reducing
unnecessary prescription drug use and cost. Here are strategies to help practices
minimize the burdens caused by prior authorization and increase the efficiency of the process.
Keys to Succeed with Pre-authorization
Prior authorizations can be a challenging aspect of medical practice, but here are
some tips to help handle them more effectively:
• Understand what the process involves: Ensure that you and your staff
understand the process thoroughly. Know which procedures and

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medications require pre-authorization, how to initiate the process, and what
information is needed.
• Documentation: Keep thorough and accurate records of patient diagnoses,
treatment plans, and the medical necessity for any procedures or
medications requiring authorization. Clear documentation can speed up the
process.
• Use technology: Consider using electronic prior authorization (ePA) tools
provided by insurers or third-party vendors, which can update the process
and reduce paperwork.
• Stay updated: Stay informed about changes in insurance policies and prior
authorization requirements. Insurance companies frequently update their
guidelines, so regular communication with insurers or attending
workshops/webinars can be helpful.
• Develop relationships: Establish good relationships with insurance
company representatives. Having a direct contact person can ease up
communication and speed up the authorization process.
• Educate patients: Inform patients about the process and its potential delays.
Encourage them to be proactive in providing any necessary information or
documentation.
• Understand appeal processes: Understand and implement the appeals
process for denied prior authorizations. Be prepared to appeal with
additional documents supporting the medical necessity of the requested
treatment.
• Track authorizations: Keep track of pending, approved, and denied
authorizations. Implement a system for tracking the status of these requests
to ensure nothing falls through the cracks.
By implementing these strategies medical practices can better handle prior
authorizations and minimize disruptions to patient care. Most practices outsource
the insurance pre authorization task to a professional medical billing company.
With a team of experienced insurance verification specialists, a reliable company
can ease the burdens caused by prior authorization, reduce risk of errors and
prevent delays in patient access to care.