Numerous cardiology procedures require prior authorization or pre-certification. While these requirements are standard in the medical field, they also interfere with practitioners’ ability to deliver prompt patient care and can interrupt a cardiology practice’s revenue cycle.
The right technology, such as Adonis’s Prior Authorization solution, can significantly reduce these challenges and empower cardiologists to focus on providing superior care.
Below, you’ll learn more about the unique prior authorization challenges that affect cardiologists and how Adonis can mitigate them.
Prior Authorization Challenges Affecting Cardiologists
Prior authorization is necessary before cardiologists can perform a wide range of procedures, including the following:
- Myocardial perfusion imaging (SPECT & PET)
- Stress echocardiography
- Cardiac CT and MRI scans
- Transthoracic echocardiography (TTE)
- Transesophageal echocardiography (TEE)
- Diagnostic heart catheterization
- Pacemakers
- Implantable cardioverter defibrillator (ICD)
- Vascular interventions
- Percutaneous coronary interventions
Regardless of the procedure, prior authorization presents multiple obstacles for cardiologists and their practices to overcome. For example, prior authorization takes up both the physician's and the patient’s time. It also reduces the amount of time providers can spend with patients and drives up healthcare costs due to its heavy administrative burdens.
A study from the American College of Cardiology found that 77 percent of doctors spent less time on patient care because they were dealing with the documentation involved in the prior authorization process.
An American Medical Association survey also revealed that 60 percent of physicians waited, on average, at least one business day for insurers to provide pre-approval for a procedure or treatment. Twenty-five percent also said they waited at least three days for approval.
For patients with severe health problems -- and most cardiovascular issues fall under this umbrella -- delayed treatment or the potential rejection of treatment altogether could cause their condition to worsen or create irreversible damages to a patient’s health.
The need for prior authorization doesn’t just affect patients’ health and well-being. It also creates an excessive administrative load for physicians. They have enough paperwork to worry about without adding the extra forms associated with precertification into the mix.
How Adonis’s Solution Enhances Access to Cardiology Care
In the same American College of Cardiology study mentioned above, 87 percent of physicians said they experience prior authorization issues at least once per week.
While they might not be able to revolutionize the process overnight, cardiology practices can at least minimize the number of prior authorization hurdles they have to clear by using a tool like Adonis’s prior authorization solution.
This tool is designed to streamline the prior authorization process while also improving practices’ revenue cycle management strategy and infrastructure. It offers the following features:
- Checks to see if prior authorization is required
- Sends requests to insurers to confirm whether or not authorization has been approved
- Ensures providers and patients know what services are approved before their appointment begins
- Eliminates the potential for denied claims or delayed payments brought on by a lack of authorization
Adonis also offers Revenue Intelligence capabilities for prior authorizations. For example, it gathers data related to critical KPIs -- including those relevant to practice front-end revenue cycle operations -- such as the prior authorization denial rate, the number of days to approval by a payer, and the number of denials per payer.
All these metrics help you understand which services produce the most revenue and which ones need to be revisited to maximize the practice’s profitability.
Conclusion
Time-consuming prior authorization processes take away from cardiologists’ abilities to spend sufficient time with patients. They can even put patients’ lives at risk.
Fortunately, investing in Adonis’s Prior Authorization technology can minimize these challenges and create a more streamlined revenue cycle management process for cardiology practices.
If you want to learn more about Adonis’s Prior Authorization and revenue cycle automation benefits, schedule a demo today using the link below.
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