Insurance Authorizations & Pre-Authorizations

Reduce Write-Offs with Fast, Accurate Insurance Authorizations

Insurance processing requirements for obtaining authorizations often delay care and impede processes for scheduling eligible, financially-cleared patients. These delays result in write-offs, unscheduled/rescheduled referrals, and higher costs.

SCI Insurance Processing and Authorization Services streamline patient access workflows for insurance authorization, insurance validation and network checks. These automated processes deliver accurate and complete authorizations directly within the SCI Patient Referrals and Patient Scheduling applications. The results: fewer denials, accelerated scheduling and referral workflows, increased referral-to-appointment conversion rates, reduced administrative tasks, lower costs, and better overall patient access experiences.

 
 

How Things Can Change with SCI's Insurance Authorizations

How Insurance Processing and Authorization Services Can Help You Accelerate Authorizations for Schedule-Ready Referrals

Increase profitability by reducing write-offs

The key is to obtain accurate authorizations before delivering care to ensure appropriate payment is covered. This reduces appointment cancellations and reschedules that often occur due to lack of authorization. With thorough documentation throughout the process, staff always know the current status and what needs to be done.

Improve efficiency and reduce costs

Drastically reduce manual authorization processes, which results in less time spent resolving claims, denials and appeals. This leads to faster scheduling for patients who have already received authorization. Across the board, staff time is freed up to focus on direct patient care and other activities.

Elevate patient and physician satisfaction

With faster insurance authorization processing, patients can be scheduled more quickly and efficiently. Referring providers appreciate the fast, transparent process. At the same time, patients receive the care they need sooner, without any financial surprises.

5 Great Features of SCI’s Authorization Services

1. Worklist with Workflow-Centric Rules Engine: Track all orders and referrals requiring authorizations in a single, web-based worklist, ensuring nothing falls through the cracks. Workflow rules automate the flow through each phase for maximum efficiency.

2. Priority Processing: Initiate authorizations quickly, typically within four hours, to ensure completion before patient arrival. Average turnaround is just 48 hours.

3. Insurance Validation: Determine right away if the patient’s coverage is active. If information is found to be missing, we work to track it down in order to confirm valid insurance.

4. Network Checks: Check patient insurance coverage against the insurer’s network and tag the referral/order as in or out of network.

5. Rules and Determination Tracking: SCI stays on top of payer rules so you don’t have to. Check first to determine if authorization is required. If one is required, manage and act upon insurer determinations through to final determination: Authorized, Request for More Information, Request for Peer-to-Peer and Denial.

Featured Resources

Data Sheet: Improving Patient Access Using NAHAM AccessKeys and SCI Solutions
Data Sheets Data Sheet: Improving Patient Access Using NAHAM AccessKeys and SCI Solutions

As a leader in patient access and care coordination, SCI Solutions hel...

Read More
How Houston Healthcare Improved KPIs with Centralized Patient Access
Webinars How Houston Healthcare Improved KPIs with Centralized Patient Access

Watch this 30-minute webinar recording to learn how Houston Healthcare...

Read More
Infographic: Centralized Patient Access 10-Point Checklist for Success
Data Sheets Infographic: Centralized Patient Access 10-Point Checklist for Success

Based upon real-world best practices from leading health systems, ther...

Read More
Checklist: Centralized Patient Access Checklist for Success
Data Sheets Checklist: Centralized Patient Access Checklist for Success

Based upon the experiences of hundreds of U.S. hospitals and health sy...

Read More
Solution Brief: Market-Based Scheduling
Data Sheets Solution Brief: Market-Based Scheduling

Market-Based Scheduling from SCI Solutions provides health systems wit...

Read More
Data Sheet: Centralized Patient Access
Data Sheets Data Sheet: Centralized Patient Access

Centralizing the patient access function gives health systems a consis...

Read More
Why Front-End RCM Matters to the Patient Experience
Webinars Why Front-End RCM Matters to the Patient Experience

This 30-minute session featuring HFMA and NAHAM Fellow, Carmen Voelz, ...

Read More
Infographic: Why Centralized Patient Access Matters for an Ideal Patient Experience
Data Sheets Infographic: Why Centralized Patient Access Matters for an Ideal Patient Experience

As patients become more accustomed to taking care of so many things on...

Read More
SCI Solutions provides the most widely adopted care coordination workflow platform for referrals, orders, messaging, results, scheduling, provider/consumer self-services and now insurance authorizations.