Are you tired of the hassle of navigating Blue Cross Blue Shield (BCBS) prior authorizations?

Do you cringe at the thought of spending hours on hold with BCBS representatives and faxing countless documents?

Well, we have good news for you. There is a way to streamline this process and save time for better health care today.

In fact, did you know that 92% of providers report that prior authorizations have increased over the past five years? (Source: AMA)

That's right, nearly every healthcare provider has encountered this headache-inducing process at some point.

But fear not, our insider guide will provide you with proven techniques to reduce time spent on prior authorizations and eliminate unnecessary stress in the process.

Equip yourself with knowledge and strategies to get the approval you need from BCBS in record time. No more being buried in paperwork and phone calls.

Get ready to wave goodbye to those headaches and say hello to a more streamlined process with less frictions to ensure you receive better health care today.

This insider guide is your go-to solution for all your BCBS prior authorization needs.

So what are you waiting for? Dive into our article and discover how you can simplify this burdensome process once and for all.

Introduction

Prior authorization is a common business practice in the healthcare system. It’s designed to ensure that patients receive appropriate care and to control the cost of healthcare. However, the process can be cumbersome, time-consuming and confusing for both providers and patients, leading to delayed care, medical errors, and extra costs. As a result, reducing prior authorization hassles has become a priority for healthcare providers and insurers, including Blue Cross Blue Shield (BCBS).

The Insider Guide to Streamlining BCBS Prior Authorization Hassles

The Insider Guide to Streamlining BCBS Prior Authorization Hassles: Eliminate Stress and Save Time for Better Health Care Today is a resource that provides practical tips and strategies for healthcare providers to simplify and speed up the prior authorization process. Developed by BCBS, the guide is based on feedback from providers on their prior authorization pain points and best practices.

What is Prior Authorization?

Prior authorization is a process that requires healthcare providers to obtain approval from an insurance company before performing certain services or prescribing medication. Insurers use prior authorization to control the cost of healthcare by ensuring that patients receive the appropriate care at the appropriate time and place.

The Problems with Prior Authorization

Prior authorization can be a significant source of stress and inefficiency for healthcare providers and patients. The process is lengthy, often requiring multiple phone calls and faxes between providers, insurers, and pharmacies. Providers may experience delays in receiving approval, which can extend the patient’s wait time for essential treatments or medication.

The Benefits of Simplifying Prior Authorization

Simplifying the prior authorization process offers numerous benefits for healthcare providers and patients. It reduces the likelihood of medical errors, optimizes treatment outcomes, saves time for both providers and patients, and improves communication between providers and health plans.

Streamlining Prior Authorization with BCBS

Reducing the complexity associated with prior authorization can improve healthcare outcomes for patients and reduce providers’ administrative burden.

Utilizing Online Tools

BCBS Prior Authorization online portal offers prior authorization assistance to providers. Providers can check prior authorization status directly rather than calling customer service to get update, enabling them to efficiently manage prior authorization request in a less stressful manner.

Transitioning to Electronic Accessibility

Electronic prior authorizations relieves adjudicators of distractions
from managing monotonous paper forms hence optimized care delivery.
Automation utilizes specific Utilization Management rules by MCG Health that adopt evidence-based clinical guidance for evaluation of the tests and treatments prescribed fighting against any biases of insurance coverage or false-negative authorization requests resulting in well-coordinated care for the patients.

Increasing Safe Prescribing of Opioids Controls

Increase in rate of Medicine Abuse or misuse and opioid deaths stemming initially
from prescription controlled substance results due to the inability or face delay in
coverage gets partial reduction with automation. Monitoring tools embedded record
a thorough history document, list prescription items interface with all previous dispensations against specific patient's overdose-related utilization history also mitigates the number of opioids to facilitate its dispension only to those that meet Federal and BCBS definitions.

Table Comparison: Before & After Prior Authorization Streamlining

Final Thoughts

The Insider Guide to Streamlining BCBS Prior Authorization Hassles provides valuable insight and tips to help streamline prior authorization processes. Automating helps digitize practises through electronic records and save time otherwise spent on faxing paperwork to reduce hea-said inconsistencies in patients' records. Such conscious care makes it possible to, amongst other things, offer better prompt specialized treatment, cater to a rising populace with chronic and complex medical conditions (something COVID-19 exposed greatly)