Insurance Authorization Services for SCI Clients

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SCI Insurance Processing and Authorization Services streamline patient access workflows for insurance authorization, basic eligibility 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 capture 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 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 Benefits 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. Eligibility Checks: 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 determine eligibility.
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.

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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.