Full-service revenue cycle and patient contact center solutions focused on maximizing operating margin.
Our experienced prior authorization team works to save time and reduce denials
Prior authorization is critical for many patients and healthcare treatments. While emergency services and many day-to-day medical treatments are insurance-authorized after the service, other procedures require pre-approval from insurance.
Global Healthcare Resource understands the complexities of prior authorization workflows and payer requirements, and our services have helped healthcare organizations better serve their patients for over 25 years. Discover how we can help your patients get necessary care faster.
Global’s experienced prior authorization professionals work efficiently and meticulously to complete:
- Coverage Analysis: We evaluate your patients’ policies and assess which treatments or procedures will require prior authorization.
- By-Case Analysis: As patient and provider requests come through, we determine whether they should be submitted to insurance before or after care administration.
- Timely Documentations: Where prior authorization is necessary, we complete and submit the required paperwork efficiently, meeting all submission deadlines.
- Consistent Follow-Up: We continue to monitor each case following submission, addressing challenges as they arise and ensuring each request moves on schedule.
Outsourcing prior authorization can transform the way your organization operates for the better. Our partners benefit from:
Eliminate the time and effort of recruiting, training, and managing staff while experienced professionals handle prior authorizations.
Global’s optimized workflows will free internal teams to focus on patient care and other essential priorities.
An international delivery model supports cost efficiency and unlocks opportunities to expand profit margins.
Step 1: We discuss your scope of work and current challenges.
Step 2: Global assembles, trains, and manages a team of highly skilled professionals to work on your project only.
Step 3: In an average of 30 days, your team is fully ramped up and operating at your designated benchmarks and KPIs.
Global Healthcare Resource’s savvy prior authorization team is ready to become an essential integration of your staff. We have experience in every major EHR system, allowing us to transition seamlessly and start submitting requests right away. When choosing a revenue cycle outsourcing company, consider that Global employs experts in hospital, physical therapy, OB/GYN, behavioral health, and many other healthcare specialties.
Find the staff support you need to keep your prior authorization requests moving and your services cost-effective and efficient. Schedule a consultation with our team today.
Patient eligibility verification is the process of confirming a patient’s insurance coverage and benefits before providing medical services. This crucial step ensures that healthcare providers receive reimbursement for services rendered. It involves checking the patient’s insurance status, coverage limits, and any applicable co-pays or deductibles. By conducting eligibility verification, healthcare organizations can minimize claim denials and streamline the billing process.
Prior authorization is necessary in patient eligibility verification to ensure that specific medical services or procedures are covered by the patient’s insurance plan. This process requires healthcare providers to obtain approval from the insurance company before delivering certain treatments, medications, or tests. Prior authorization helps control healthcare costs, prevents unnecessary procedures, and ensures that patients receive appropriate care based on their insurance benefits.
Global Healthcare Resource ensures HIPAA compliance by implementing strict policies and procedures to protect patient information. This includes conducting regular training for staff on HIPAA regulations, utilizing secure electronic systems for data management, and ensuring that all communications involving patient data are encrypted. Additionally, Global Healthcare Resource performs regular audits and risk assessments to identify and mitigate potential vulnerabilities in their data handling processes.
Global Healthcare Resource verifies a wide range of insurance types, including private health insurance, government programs such as Medicare and Medicaid, and managed care plans. They work with various insurance providers to ensure comprehensive eligibility verification for patients, allowing healthcare organizations to efficiently manage their billing processes and reduce claim denials.
The eligibility verification process typically takes anywhere from a few minutes to a couple of days, depending on the complexity of the patient’s insurance plan and the efficiency of the verification system used. Automated systems can expedite the process, allowing healthcare providers to receive real-time updates on patient eligibility. However, manual verifications may take longer due to the need for additional documentation or communication with insurance companies.
Outsourcing eligibility verification offers several benefits, including:
