In the ongoing debate about the public healthcare option and President Obama's proposed plan, there remains the question of what will happen with prior authorization.
From the many articles recently released, it does not appear that it will go away anytime soon. An article from Mass Device, written by E. Berger, Aug 2009, states "The healthcare reform legislation working its way through the Congress seems likely to include a proposal to establish (for Medicare or any publicly managed program) Radiology Benefit Managers(RBMs) organizations which would review and approve the appropriateness of referrals for advanced imaging". Another article, RBMs Are Part of Obama Plan from Radiology Today also describes how prior authorization for advanced imaging may be included. This initiative, if passed with the healthcare bill, will make prior authorization for advanced imaging(MRI, CT, PET scan, nuclear medicine) even more of an issue for medical offices.
Every study requested will have to be precertified prior to performing.Most commonly the staff designated to perform this function are non-medical staff, secretaries, office managers and billing personnel.Through no fault of their own, no specific training is available.That is why I have developed a training program to provide staff with the tools to understand this process and provide a clear clinical picture to eliminate delays and denials.Now is the time to be proactive in preparing your staff.Visit my website for more details on how I can train your staff to be prepared for this monumental change. http://www.rosewoodconsulting.biz/