Precertification: Prior Authorization And Care Delays

Precertification And Care Delays

It’s well-established that precertification causes an office to work less efficiently. We’ve discussed how it affects client experience, contributes to the stress of employees, and costs time and money — lots and lots of time and money. In fact, in a previous blog post, we discussed how you can expect an average annual cost of $28,000 per provider to do precertification in-house.

In today’s blog post, we want to take a look at the role that in-house precertification play in care delays. According to a report released last year from the American Medical Association (AMA), precertification issues are associated with 92 percent of care delays. There’s reason to be optimistic for institutional changes to help with these (as we looked at in our previous blog). Additionally, outsourcing precertification through AuthNet can help mitigate the ample costs of precertification. Be sure to contact us to learn more about making your office more efficient. In the meantime, let’s take a closer look at the effect of precertification and care delays.

The AMA Survey

In March of 2018, the AMA surveyed 1,000 patient care physicians. The aim of the survey was to explore the overall experiences of being a patient care physician. This survey found that more than 9 out of 10 physicians feel that precertification programs have a negative impact on patient clinical outcomes. According to the AMA, “The survey results further bolster a growing recognition across the entire health sector that prior authorization programs must be reformed.” Physicians ultimately feel that the precertification process can be “a lengthy administrative nightmare of recurring paperwork, multiple phone calls,and bureaucratic battles that can delay or disrupt a patient’s access to vital care.”

Physicians And Care Delays

The high wait times for preauthorized medical care have consequences for patients. The report shows that 92 percent of physicians said that the precertification process delays patient access to necessary care. Additionally, nearly 4 in 5 physicians (78 percent) report that precertification leads to patients abandoning a recommended course of treatment.

It’s not surprising that precertification could have such an effect on the course of treatment of patients. As the survey went on to show, the majority of physicians (more than 60%) report having to wait a full business day for precertification decisions from insurers — and around a third report waiting three business days or longer.

The Benefits Of Outsourcing

In short, the survey demonstrates the burden associated with in-house precertification processes. It shows that a significant majority of physicians consider the burdens associated with precertification to be high or extremely high and that there’s a critical need for things to change.

That’s where AuthNet comes in. The extreme costs associated with precertification can be lifted through our services. As a leading provider of precertication processes and services, we undertake the burden so your office doesn’t have to. Work with experts who can help with costs, assist with insurance authorization, and allow you to remain focused on delivery of care. Cut back costs and focus on what really matters by contacting AuthNet today.