Presenter: Mona Reimers

Insurers require permission for office visits, medications, surgeries, medical devices and therapies – and the list continues to grow. At the same time, insurers are adding to the amount of medical information they require before granting permission for patients to have the services they need. And because the insurers’ processes are so flawed, re-work and wasted effort is everywhere. Hospitals and other third parties involved in care often need to share the precert information, adding yet another required communication that eats away at staff time. It is no wonder that fear of a missed authorization or a denial often causes staff to start hoarding paperwork and causes them to constantly “double check” their work, reviewing the same lists over and over. The session will demonstrate unique ways to use Centricity’s scheduling and EMR tools to reduce the time and work needed to obtain pre-certification. The session will show proven results to make “biggest losers” out of the precert department liberating them from re-work and resolve hoarding issues. Participants will also see management tools that can monitor work in progress, time frames for completion, and monitor individual employee contributions to the prior authorization department. The speaker will reveal and automated method to communicate prior authorizations with third parties and can nearly eliminate phone calls between third party providers (like hospitals and labs) to communicate about prior authorizations. Finally, the session will show how workflows using Centricity’s EMR can quickly communicate with the clinical staff and begin to resolve precert denials effectively and efficiently. In summary, this session will demonstrate how using the flexibility of EMR and the PM data sets, every practice can stop (or greatly reduce) the hoarding of printed documentation and become the biggest losers of costly staff time, re-work and denied authorizations.