Wednesday, October 21, 2009

Commonly Asked Question: How Did I Get This Idea for Prior Authorization Training?

I frequently am asked how this idea for training of prior authorization for advanced imaging(MRI, CT, PET and nuclear medicine) came about. Years ago when I first started working for one of the largest advanced imaging management companies, I spoke with medical offices everyday. One out of three offices providing clinical were not able to answer the questions I was asking to approve the study. In that case, the study immediately gets sent for medical review. It becomes frustrating for both nurse reviewer and the staff member providing clinical. There is no formal training for medical offices. Some medical offices said they had never done a prior authorization before. Talk about on the job training!
After being on the job for about six months, I began to think about how medical staff could be trained and how that would make the process easier for both sides. That is where the idea began. Years went by and it seemed like nothing changed. Many of the medical office's staff members were still confused and unable to provide adequate clinical. Many reasons for this are outlined in my article, Prior Authorization for Advanced Imaging, A Nurse Reviewer's Perspective. It was two years ago that I started writing the article. I began to think about all the common mistakes and errors that led to requested studies being delayed or denied. Now, after many years of compiling this information and writing my article, I have created an affordable and easy training program to help medical staff or anyone who does prior authorization for advanced imaging to be able to give a clear picture to the nurse reviewer, answer questions easily and avoid the red tape associated with this process. You will find that studies will be easier to precert and that stress/frustration will be eliminated. Feel free to post a comment or start a discussion about issues you have had with the prior authorization process.

No comments:

Post a Comment