Sunknowledge Service: Cracking Successful Prior authorization Solution for DME

prior authorization for DME

According to a recent survey which is the forecast of 2019-2026 done for the region of North America, MEA, APAC, Europe by the end user (hospitals and nursing homes) stated; the durable medical equipment (DME) market size to increase USD 271 billion by 2026 registering a CAGR of 6.1%.

Due to the increase in the number of aged people everywhere, the DME market is growing in larger aspect. It is estimated that technological advancement along with strong reimbursement will boost the DME market. Even though there is arising in the DME market, prior authorization is still a problematic matter to deal with.

Where to Find a Perfect Prior Authorization Answer for DME?

Sunknowledge Service Inc a 360-degree practice management/revenue cycle management expertise in such effective prior authorization services, ‘PriorAuth Online’.

Complete DME Prior Authorization Platform:

PriorAuth Online provides effective and faster prior authorization solution, with 100% prior authorization submission on the same day and also increase in your PA rate by 1.5-2x. Our prior authorization for successful DME involves:

Gathering Information – it starts with the collection of information. This includes patient name, DOB, insurance information along with ordering provider’s name, NPI, Tax ID, address and phone no. Even checking whether ordering physician is PECOS certifies is done by us alone with the place of service, service codes, diagnosis code and units for each service code.

Contacting the Payer – this process is followed by authorization request submission, i.e. portal, fax, phone etc. This is followed by contacting for UM/Prior authorization department, fax to send medical notes if required.

Our Predetermination, Initiation and Follow up Activities – Checking to determine whether the patient is eligible based on payer requirements for prior authorization. This again is followed by initiating prior authorization as per payers’ protocols/guidelines, following up with payer via outbound calls, portal etc to check authorization status and following up with ordering physicians’ offices for medical notes, therapy charts other documents etc (if required). This ends with providing additional documents/ information if requested by the payer.

Update Authorization – outcome in the PM/billing system about the date, authorization and units.

What Makes Sunknowledge Different?

Apart from proving successful prior authorization for DME and 27 other specialties, we are the only RCM organization proving pre-billing activities. This includes order entry; eligibility verification and authorization (Online/ calling); authorization initiation and follow-up. Even collection of documents, doctor’s office follow-up, reauthorization, order Confirmation and scheduling of delivery is also done by us

Other Facilities Provided by Sunknowledge:

  • 70% instant cost reduction with complete operational transparency
  • 97% highest collection rate with 30% shrink in AR bucket
  • 9% accuracy rate with the highest productive metric in medical domain
  • Customized robust report, according to the client’s protocol
  • No writes off is done without client consent
  • Errors of Omission & Commission Insurance support from Hiscox/Geico with Liability Cover of $1 million
  • No hidden cost and no binding contract

For more information call Sunknowledge expert over a ‘no commitment call’ and experience effective and faster revenue generation prior authorization solution for your DME and other specialties.

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