Hmmm. Sounds like issues with Prior Authorization & Notice of Admission. NOA workflows can be intensely fax based as well. Some health plans offer an electronic 278 submission offering, but we are hearing that teams need to login to web portals to obtain authorization confirmation and tracking codes. To read the entire article click here: Family claims Atrium Health didn’t obtain pre-authorization prior to hospitalization.
Also, coordinating the auth/NOA approval with Case Management is key to getting clinical documents to the payer in a timely manner. VALER® has now added Notice of Admissions to automate fax and web portal workflows, provide date & time-stamped documentation of activities, and workflow collaboration between teams to avoid pesky denials. #FixPriorAuth #VALER #Patient Access #priorauthorization #AMA #APGColloquium2020 #MGMA
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