10 steps to streamline Prior Authorization in Orthopedic

Verify Eligibility & Benefits Early – Check insurance status and prior auth needs before the patient leaves.
Collect Documentation Upfront – Gather notes, imaging, and therapy records at the start to prevent denials.
Understand Payer Policies – Keep updated payer guidelines accessible to avoid outdated info errors.
Centralized Tracking – Record requests, submission dates, and follow-ups for real-time visibility.
Leverage Technology – Use EHR and practice management tools with alerts to minimize manual errors.
Dedicated Specialist – Assign a staff member to manage authorizations, appeals, and payer relations.
Proactive Follow-ups & Appeals – Regularly check pending requests and maintain a structured appeals process.
Analyze Denial Trends – Review data to spot weaknesses and refine policies or training.

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Verify Eligibility & Benefits Early – Check insurance status and prior auth needs before the patient leaves.
Collect Documentation Upfront – Gather notes, imaging, and therapy records at the start to prevent denials.
Understand Payer Policies – Keep updated payer guidelines accessible to avoid outdated info errors.
Centralized Tracking – Record requests, submission dates, and follow-ups for real-time visibility.
Leverage Technology – Use EHR and practice management tools with alerts to minimize manual errors.
Dedicated Specialist – Assign a staff member to manage authorizations, appeals, and payer relations.
Proactive Follow-ups & Appeals – Regularly check pending requests and maintain a structured appeals process.
Analyze Denial Trends – Review data to spot weaknesses and refine policies or training.