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.