Sleep Review Magazine featured CareCentrix Senior Medical Director, Amy Aronsky, in their piece, “9 Techniques to Clear Hurdles for Home Sleep Testing Preauthorization.” The piece focused on how sleep therapy providers can streamline the home sleep testing preauthorization process.
Preauthorization for home sleep tests
Sleep medicine providers share the common goal of providing swift and effective care for their patients, but preauthorization for home sleep tests (HST) can sometimes stall this process and siphon resources away from patient care.
Long telephone hold times with third-party payors can interrupt the workflow of administrative staff and can be arduous to document in electronic health records. Faxes containing clinical documentation for preauthorization are often filled out by hand and must be manually entered into the patients’ electronic health records. Some sleep medicine offices hire full-time employees just to take on the extra work of getting HST preauthorization for their patients.
“They make it so that it is expensive for us to get the patient the test,” says Michael Zachek, MD, a sleep specialist who treats patients in Kentucky. “If you can answer the questions [for preauthorization] in 10 minutes, why does it take some providers 15 working days to get the answers?”
Medical office employees report spending hours navigating through individual insurance company’s websites or sitting on the phone, waiting to get through to the appropriate person to seek approval for a relatively low-cost test that is almost always approved.
Streamlining the preauthorization process
To avoid unnecessary frustration, CareCentrix’s Amy Aronsky and other sleep medicine professionals have provided some must-follow tips that can help streamline the process.
Small mistakes can hold up the preauthorization process, so study the clinical criteria for each insurance company, says Amy Aronsky, DO, FAASM. “Make sure you have all the pertinent clinical information that is going to support the diagnosis that you are looking to make and that the documentation supports the clinical guidelines.”
Read the full article via Sleep Review Magazine, here.