The Sunknowledge Story in Prior Authorization

Created by WebAdmin
On Aug 8, 2018
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Sunknowledge has understood precisely the challenges with everyday practice management. A streamlined effort to improve prior authorization is our objective. We start working as a reliable operational extension; provide all the support with transparent sharing of information.
We will implement sound checks and balances that better your cash flow. As we work by performing task specific activities in eligibility verification and authorization, denial management and accounts receivable recovery, we constantly improve your revenue cycle management priorities!

Our prior authorization automation approach with a case study
A health plan that was specializing in State Medicaid business was using a manual process with prior authorization and had to access multiple systems to gather information and also to disseminate decisions.

The Sunknowledge Approach in Botox Prior Authorization
Managing prior authorization for a quasi medical item Like Botox can be a challenge. Primarily used for cosmetic purposes, we followed a successful pursuit with a diligent understanding of the claims adjudication mandates. As an expert, we have the confidence and combine with all major practice management systems in the marketplace.
Since it requires more effort than conventional medical procedure, we have the ability to successfully liaison with the insurance company, the specialty pharmacy that will deliver it as well as the prescribing physician. We lay down the right checks and balances by performing task specific activities in Botox Prior Authorization. We will perform all the activities that includes : verification of eligibility, initiating the authorization, follow- up on the request, obtaining and acknowledging authorization, scheduling the delivery of the drug.
By working as your ultimate partner with operational best practices, we will collect the required forms, the medication documents, getting in touch with the insurance companies and providing a rigorous follow up process. Also, we will update the billing system with the authorization status as well as call up the specialty pharmacy for drug delivery.