Lets talk about why we are offering you Hassle-Free Authorizations

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Presentation transcript:

Lets talk about why we are offering you Hassle-Free Authorizations ICN-4175 REV 3

PREAuthorization Challenges Have you seen an increase in preauthorization requirements from payers?  Yes  No  N/A MGMA Stat 2016 STAT #1 A recent poll of clinicians and their staff has seen huge increase in preauthorization requests from their payers With these authorizations come various, and complex rules STAT #2 Preauthorization continues to be a burden for referring physician offices. It’s the 3rd highest dissatisfaction part of ordering images from their rendering providers NET: Let us take that burden off of your staff’s hands and automate it for a better imaging experience. Top Reasons for Referring Physicians Dissatisfaction Preauthorization 32.8% Reports: Turnaround Time and Quality 34.2% Scheduling & Registration 53.5% Radiology Business 2014 ICN-4175 REV 3

Are you doing Manual PreAuthorizations? 83% $4549 80% of 300 surveyed clinicians and their staff say that adding electronic preauthorization is a priority1 is the cost for clinicians and staff to do one preauthorization, manually. 2 Follow-up and rework cost on, average an additional $25.3 of preauthorization requests require extra work, rework or phone/fax follow-ups.4 Everyone knows preauthorization is a hassle. STAT 1 Surveys done on preauthorization confirms that clinicians and their staff think it should be easier. ‘Wanting’ and ‘getting’ are two different things, however, as clinicians and their staff ask the same questions in healthcare, ‘isn’t there an easier way to do this?’ STAT 2 The cost per authorization/interaction with insurance companies varies, although most studies confirm it can be as costly as it is frustrating. Referring offices incur this per cost average while not getting reimbursed STAT 3 If cost and headache aren’t enough, 80% of the time extra work, redundancy in work or re-work is required. That re-work adds more time, cost and frustration to this antiquated process NET Why deal with all of the above if you don’t have to and it doesn’t have a positive impact on your business? Per the Office of Inspector General (OIG) ruling5, we can now take this cost and time burden off your hands! 1. Survey conducted by Physicians Practice and HIMSS Media from Nov-Dec, 2015 2. “2014 CAQH Index: Electronic Administrative Transaction Adoption and Savings 3. “How to avoid ‘unclean’ claims” MGMA Connection Plus, March 28, 2014 4. Wayne Oliver: Electronic Prior-Authorization White Paper Final Mar 2012 5. OIG Advisory Opinion No. 10-04

‘Hassle-Free’ Authorizations BENEFITS FROM THIS SERVICE With the OIG ruling, radiologists can now assume the burden of preauthorizations to ensure timeliness and appropriateness. Scheduling and receiving exam results will become faster with a more transparent workflow. Allows you and your staff to refocus your time and attention on more important tasks, like patient care. REMOVING THE PAIN OF PREAUTHORIZATION This new service will allow us to manage all of your preauthorization needs. The only change to your workflow to achieve this? A clinical note. By providing a clinical note with the order for your patient, we can automate this process directly by connecting the appropriate payer to obtain the preauthorization and schedule your patient. We will get the preauthorization approved, perform the study and get the results back to you…that’s our promise to you. ‘Hassle-Free’ Authorizations Benefits: With the OIG ruling, we can now provide this service for you, cost-free. You saw the Stats in the previous slides, and now we can eliminate or reduce that frustration by inheriting this burden. With this automation, we are committed to providing a better experience, from scheduling to results, for you and your patients You and your staff’s time can re-focus your time and abilities to more important tasks, such as patient care and engagement Flexibility: We have various levels of interoperability. EHR interfacing does add a cost, but your workflow will dramatically improve without having to adjust add to your workflow. Our portal will allow you and your staff a quick link to the automation process, and provide transparency into the tracking of your patient Lastly, if you want to send your preauthorization requests the same way you do with your orders, we can do that. *Note to IMAGING CENTER: we do need a clinical note to complete this manually* NET: Whatever works for you, will work for us, as we intend for this service to make life easier for you.

HOW DOES IT WORKS? This automated, hassle-free preauthorization service is made possible through our partnership with Merge, an IBM Company, in collaboration with industry-leading RBMs eviCore and AIM. Although AIM and eviCore cover 132M members combined, we can secure preauthorizations for patients that fall outside of these plans. Covering solutions to streamline the referral process Preauthorization made possible with iConnect® Network Services Proven, innovative interoperability solutions Partnering with eviCore Healthcare and AIM Specialty Healthcare Automating the preauthorization process for imaging orders Covering a wide-range of clinical expertise More than 42 million members managed 4.9M Medicaid recipients 1.9M Medicare Advantage members 100 board-certified primary care and specialty physicians reviewers Covering all lines of business More than 90 million members managed Commercial fully-insured, self-insured, retail exchange Medicare, Medicaid, federal ACO lives in risk-based models These 2 RBMs are built to understand the various payer rules on authorization. There was a study done on 23 major health plans and 1,300 procedures that required authorization…there was only an 8% commonality between them all! This automation will take out the bias and redundancy that preauthorization is known for.

Contact Us for More Information Your Company Name Address City, ST ZIP phone We Are Social: www.yourURL.com Facebook.com/companyname Twitter.com/CompanyName Linkedin.com/company/company name Rendering facility can add their contact and social media info Insert Jira Number 6 ICN-4175 REV 3