Our client is a team of pain management specialists, including MDs and Nurse Practitioners, based in a prominent medical center in Texas. They provide customized treatments to improve patient well-being using advanced techniques and equipment. Their focus on individualized care ensures superior outcomes and patient satisfaction.
The client faced significant revenue losses due to a surge in authorization denials. These issues were compounded by scheduling delays from increased patient inquiries and lengthy authorization processes. The traditional system, with limited staff, struggled to handle the rising volume of requests efficiently.
To address these challenges, we redefined their authorization management strategy. Our team optimized resource allocation by adding skilled personnel and integrating offshore units with onshore teams for cost-effective management. Virtual systems ensured smooth coordination between onshore and offshore teams, while regular audits maintained high service standards. We utilized Finnastra software, adhering to HIPAA compliance, to manage prior authorization efficiently.
Our approach resulted in an 85-90% increase in authorization approval rates, significantly reducing revenue loss. We cut the authorization turnaround time from 10 days to just 3, improving productivity and service quality. Patient satisfaction, particularly among the elderly, rose due to faster processing and enhanced care delivery.
