Understanding Payer Website Authorization Variables

Prior Authorizations clearly save money for the insurance companies, but ultimately they end up costing the health care system. Navigating the various payer websites searching for an authorization can be time-consuming and frustrating for a registration clerk, largely due to each payer having required fields to be completed prior to retrieving the authorization number.

Another frustrating component is that payers have different terminology for authorizations, such as Referral Number, Case Number, and Approval Number. It is hard to determine if, in fact, the service has been approved by the payer, not taking into account the services that are “Pending Review” by the payer.

Finally, there are a limited number of payers that participate in 278 Transactions (Prior Authorization Review Request and Response,) and of those limited number of payers, a select few can be scraped to retrieve the Authorization number.

The good news is that AccuReg has already done all the research! We know how to navigate the various payer websites but more importantly, we know which sites can be scraped for the Authorization number! So sit back and let AccuReg do the work for you. For more information about AccuReg Authorization Management, click here!