Insurance Authorizations & Pre-Authorizations

AVOID DENIALS WITH RELIABLE INSURANCE AUTHORIZATIONS.

Speed the process for obtaining insurance authorizations for referred patients to avoid care delays, reschedules and denials.

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, faster scheduling and referral workflows, higher referral-to-appointment conversion rates, reduced administrative tasks, lower costs, and better overall patient access experiences.

 

SCI's Insurance Authorizations Improves Operations

How Authorizations
help you

Increase profitability by reducing write-offs

The key is to obtain accurate insurance authorizations before delivering care to ensure appropriate payment is covered. This reduces appointment cancellations and reschedules that often occur due to lack of insurance 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 insurance 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 Insurance Authorizations

1. Worklist with Workflow-Centric Rules Engine: Track all orders and referrals requiring insurance 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 insurance 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 insurance 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.

"Reschedules caused by lack of authorization are down by more than half and physician satisfaction is up."

Andy Terry, VP, Revenue Cycle, Baptist Health Care

Featured
Resources

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, ...

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Health First Panel: Streamline Orders and Scheduling Across Your Network
Webinars Health First Panel: Streamline Orders and Scheduling Across Your Network

Health First realizes big benefits, including a 20% reduction in call ...

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Infographic: 3 Ways Authorizations Cost More Than You Think
Data Sheets Infographic: 3 Ways Authorizations Cost More Than You Think

Learn about the hidden costs of manual insurance authorization proce...

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Live Panel Discussion: Baptist Health Care and Baptist Medical Group
Webinars Live Panel Discussion: Baptist Health Care and Baptist Medical Group

Baptist Health in Pensacola coordinates care and authorizations with c...

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Intro to Insurance Processing & Authorization Services
Product Demos Intro to Insurance Processing & Authorization Services

Watch this short video describing the benefits of SCI’s Insurance P...

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Insurance Processing and Authorization Services Demo
Product Demos Insurance Processing and Authorization Services Demo

Watch this short video demonstration showing the steps in the Ins...

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Introducing SCI Insurance Processing & Authorization Services
Data Sheets Introducing SCI Insurance Processing & Authorization Services

Simplify and accelerate authorizations for schedule-ready referrals. ...

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