Complete DME Prior Authorization Guideline with Sunknowledge Solution

Prior Authorization for DME

Today the main concern of healthcare provider is that the process of prior authorization is affecting the physicians’ ability to provide proper care to patients. As normally health plan has to go through the approval check post of prior authorization for ensuring correct medication. In fact to get a larger perspective and effect of the prior authorization process AMA (American Medical Association) have conducted a survey. The survey had reported increase prior authorization rate and even prior authorization responsible for a serious adverse event. In fact, the online survey of December 2018, by AMA on U.S based physicians; where 40% were primary care physician and 60% were of other specialties gave a clear picture of the current prior authorization situation.

Time-Consuming Process:

  • 65% of physicians reported waiting an average of one business day for a prior-authorization approval.
  • 26 %reported waiting for the approval for a minimum of 3 days.
  • 7 %reported waiting an average of more than five days.

Increased Administrative Burden

  • 86 % of the physicians said Prior Authorization create a high level of stress
  • 88 % said the burden had increased over the last 5 years.
  • Physicians processed an average of 31 prior Authorization per week.
  • Up to 36 % reported that the complex process requires dedicated staffs exclusively to PA.

Negative Impact on Patient Care

  • More than 9 in 10 respondents reported the process of Prior Authorization had somewhat negative clinical impact.
  • 28 % reported Prior Authorization had led to serious adverse health effect for patients
  • 91 % think that Prior Authorization delays patients’ access to care.
  • 75 % believe that Prior Authorization can lead to discontinuing patient treatment.

Why Sunknowledge?

This is why finding the perfect DME prior authorization is very vital. Sunknowledge Service Inc specialized in such prior authorization service ’PriorAuth Online’. As more than 50% of our work involves in DME domain with annual revenue of 1.6 billion, this making us excel in DME prior authorization services.

Authorization we Follow:

  • Gather vital information on medical procedure, patient, and provider
  • Verify and validate prior auth request with effective payer side communication
  • Check the patient’s eligibility
  • Initiate the auth request based on the payer mandates
  • Checking the auth status
  • Collating relevant documents from the ordering physicians/follow up
  • Providing additional information if any
  • update the auth income in the PM/Billing system

Solve your DME Prior Authorization by Partnering with us

So if you want a 100% prior authorization submission on the same day and increase the rate of prior authorization by 1.5-2x, Sunknowledge is the perfect operational extension. Our expert will provide you operational transparency solving and easing all your DME prior authorization and prior authorization of other specialties too.

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