Medical Authorization VA

A medical authorization virtual assistant (VA) is an administrative medical assistant that concentrates on handling insurance authorizations for you. It may seem excessive to hire a virtual assistant specifically for authorizations. However, in reality, despite the fact the authorization process was created for better safety and to supposedly save time, it is often a time-consuming endeavor.

Prior authorization in healthcare is required to protect both patients and health care providers so that neither bears the brunt of paying the cost of a rejected treatment plan, but processing can take anywhere from a day to a month. Despite being part of the patient’s side of medical cost management, authorizations are the responsibility of the healthcare provider to acquire. Unfortunately, the variable time it takes to complete the medical pre-authorization process means that up to a month of a provider’s time is used up on bureaucracy instead of coming up with better patient treatment plans. As such, hiring a medical authorization virtual assistant for handling getting authorization from insurance is definitely a good idea.

A medical authorization VA can also handle different types of authorization in medical billing. If prior authorization doesn’t work out, they can also handle referrals, and even retro authorization when the latter becomes necessary.

• Keep patient files up to date

The first step to acquiring that much sought-after pre-authorization number is submitting pertinent patient details. As such, your medical authorization virtual assistant must aid in keeping all patient records updated. Having a clean patient database goes a long way to shortening authorization processing time, and your VA should help you be on top of this.

• Check insurance policy rules

A medical authorization VA’s primary task is to get prior authorization for treatment plans. Looking at different health plan rules and policies is one of the first things they have to do for this. They will usually start to manually look into patients’ specific insurance plans because of the large variation of healthcare plans and the lack of integration between different billing systems. A medical authorization VA can utilize a mix of online insurance authorization services, paper, and digital documentation to determine whether or not pre-authorization is required, and the necessary steps to acquire it.

• Determine applicable CPT codes

The next step in pre-authorization in medical billing that your VA needs to take is to find out the CPT codes that are applicable to the prescribed treatment plan. Including all the correct codes ensures that the patient’s health plan is maximized, and gives a better case for your authorization request.

• Preauthorization follow-ups

As is often the case in any bureaucratic process, simply submitting all the requirements is not the end. Your medical authorization VA takes care of following up with insurance companies until your office gets a clear resolution from the company, whether it be approval, denial, or even redirection.

• Process referrals

If you need to refer patients to a different specialist, your medical authorization VA can also process the requirements for a referral request. This is important because it saves time for both your clinic and the clinic of the healthcare professional you are referring to, especially because some insurance companies need active referrals for some tests or procedures. A failure in the proper referral request can mean a failure in reimbursement later on, so it is important that your VA also keeps track of this.

• Organized and detail-oriented

A medical authorization specialist has to handle many requests all at different stages at a time. They, therefore, have to be very meticulous in their record-keeping, and able to pull up and refer to the proper information at a moment’s notice.

• Able to communicate well

Medical authorization VAs have to do a lot of digital and verbal communication with insurance providers, patients, and the medical office staff in order to get their jobs done. It’s important that they can establish good rapport and can speak with different stakeholders clearly and appropriately.

• Patient

Medical authorization can take a lot of time and re-tries. As such, being patient is an important quality to have for a medical authorization VA. A patient disposition can lead to fewer details falling through, and of course to better, more stable communication between stakeholders.

• Has integrity

Medical authorization VAs are privy to a lot of private patient information. It’s important that they’re trustworthy in order to keep patient data secure.

While hiring a medical authorization specialist is cost-efficient in the long run, hiring one can take time and effort you currently don’t have. Hiring a company like 20four7VA can help you get a good VA without the hassle. They can sift through the global talent pool and present to you only the best, most fitting candidates for interview.

20four7VA doesn’t just stop there. Once you’ve interviewed the candidates and chosen who you like, the company can help you onboard the VA and later on even monitor your VA, so that there is much less procedural overhead for you. You can start looking for your medical authorization VA by booking a no-obligation pre-consultation call now.