Winning the Paperwork War: Prior Authorization Best Practices for Internal Medicine

  • Prior Authorization Challenges: Internal medicine practices face care delays, increased admin work, varying insurer rules, and payment denials due to prior authorization.
  • Major Impact: 94% of doctors report delays in care; 33% witnessed serious patient health issues because of it (AMA 2023).
  • Best Practices:
    • Track insurance-specific rules.
    • Standardize prior authorization workflows.
    • Use electronic prior authorization (ePA) tools for faster approvals.
    • Train staff regularly on documentation and appeal processes.
    • Analyze denials to fix recurring issues.
  • New Trends:
    • CMS’s 2025 ePA mandate for faster, uniform processes.
    • AI-powered tools for automation.
    • Real-Time Benefit Checkers for instant drug coverage info.
  • The Cost of Delay: 14 physician-hours per week lost; patient satisfaction and practice revenue suffer.
  • Practolytics Advantage: Expert help with prior authorizations, faster approvals, fewer denials, real-time updates, and happier patients.
  • Outcome: Reduced admin burden, more time for patient care, and a smoother approval process.

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      • Prior Authorization Challenges: Internal medicine practices face care delays, increased admin work, varying insurer rules, and payment denials due to prior authorization.
      • Major Impact: 94% of doctors report delays in care; 33% witnessed serious patient health issues because of it (AMA 2023).
      • Best Practices:
        • Track insurance-specific rules.
        • Standardize prior authorization workflows.
        • Use electronic prior authorization (ePA) tools for faster approvals.
        • Train staff regularly on documentation and appeal processes.
        • Analyze denials to fix recurring issues.
      • New Trends:
        • CMS’s 2025 ePA mandate for faster, uniform processes.
        • AI-powered tools for automation.
        • Real-Time Benefit Checkers for instant drug coverage info.
      • The Cost of Delay: 14 physician-hours per week lost; patient satisfaction and practice revenue suffer.
      • Practolytics Advantage: Expert help with prior authorizations, faster approvals, fewer denials, real-time updates, and happier patients.
      • Outcome: Reduced admin burden, more time for patient care, and a smoother approval process.