Even today with years of authorization process, healthcare practices still experience difficulties in achieving a seamless authorization status be it for DME, HME, orthotics, infusion, or even prosthetics prior authorization etc. Being one of the most complex and time taking process, a prior authorization requires an expert who is not only are skilled but has a complete authorization knowledge along with changing regulations and norms and aware of facts like:
- Consideration of restrictions based on the time within which the item can be covered if supplied earlier.
- Billing of suitable modifiers, e .g. KX, LT / RT, NU etc.
- Coverage of gadgets additionally subject to qualifying diagnosis, e.g. orthotic shoes are not secured unless diagnosis states diabetic
- Repair, replacement and supplies may be eligible for divided compensation especially for prosthetics prior authorization.
As even a single mistake can be the reason for denial and rejection of claims and loss or disruption in the cash flow.
The most common reason for prior authorization can be many but here are a few common ones like:
- The HCPCS codes is not subjected to the authorization required
- Duplicate prior authorization request submitted
- Incorrect or incomplete information and also delay in submission
- Prior authorization request sent to the incorrect jurisdiction and many more
However, with the right operational extension, you no longer have to worry anymore.
Sunknowledge Services Inc: a prosthetics authorization solution
Taking care of all your prosthetics prior authorization problems, Sunknowledge Services Inc not only ensures a seamless prior authorization process but also a faster reimbursement rate. Maintaining a 99.9 % accuracy rate with its stringent checks and balances, our experts not only reduces your authorization errors but also decreases your chances of claims rejection as well along with 80 percent of operational cost reductions. In fact with complete authorization knowledge and understanding along with claims adjudication priorities of the payers, we today ensure the highest collection rate of 97% with a complete operational transparency and customized robust reporting for all our clients.
With a prior authorization submission on the same day, our experts further increase the authorization rate by 1.5-2x closing all the prosthetics authorization gaps faster so that you can focus more on patient care.
So if you are looking for an improvement in your prosthetics authorization process, we are the one.
