New blog series called: "Did you know?"

For the next few blogs I will address some of the most common issues related to advanced imaging and the preauthorization of such studies in a non-urgent setting.
Did you know that an MRI brain without contrast is the preferred study for the sole complaint of worsening headaches in a patient without any underlying medical history? For a patient with cancer or a known brain tumor, the preferred study would be an MRI brain with or with/without contrast. Of course, if an MRI is contraindicated, CT would be the preferred study.
Many medical providers choose CT because they think it is cheaper and will be easily approved by the insurance company/advanced imaging management company. MRI can actually be cheaper in the long run. Specifically, when a CT is done and it comes back negative. If the patient continues to have symptoms an MRI is ordered anyway. Most importantly, MRI is the preferred study for neural imaging. Dr. Robert B. Daroff said at the annual meeting of the American Headache Society, "sensitivity of an MRI scan far exceeds that of CT scans for all neurologic conditions, not just headache".
Medical providers should think twice about ordering a CT vs an MRI for nonurgent conditions. Not only can an MRI save money in the long run, it prevents radiation exposure and gives better results.

I remember....

I remember at the end of the day when working with medical offices, talking with them on the phone and collecting clinical information for prior authorization, I would think to myself how I would love to be able to teach them what I know. Hearing the frustration and stress in their voices and their words, I wish I could show them where to look for information, how to read the doctor's note, what the labs mean, why ordering an MRI brain is better than ordering a CT scan for headaches. All this has now come true. I am teaching staff all of these things and more! Being a nurse, what a great way for me to help patients by teaching medical staff.
If you are feeling frustrated and stressed out with this process, contact me at http://www.rosewoodconsulting.biz/
There is no obligation and no high pressure sales pitch.

I expect to pass through life but once. If therefore, there be any kindness I can show, or any good thing I can do to any fellow being, let me do it now, and not defer or neglect it, as I shall not pass this way again. ~William Penn

Medical Office Staff Are Stressed Out!

Seems like everyone is so stressed out these days! Today medical office staff are overworked and tasked with new duties for which there is minimal training. I know, I have been there, working in many medical offices over the past 10 years. On the job training was the rule, not the exception. And for the past 5 years as a nurse reviewer for one of the largest advanced imaging management companies, I have heard from many medical office staff how stressful their days have become. Coordinating care with patients, doctors, insurance companies and other medical facilities all at one time can be extremely stressful. The University of Pittsburgh Medical Center writes,"studies show that stressful working conditions are actually associated with increased absenteeism, tardiness, and turnover--all of which have a negative effect on the bottom line." This is a serious problem. One of the ways stress can be reduced with the prior authorization process(aka predetermination) is by having proper training. Stop the stress and frustration associated with this process by viewing my website to see how I can help.
http://www.rosewoodconsulting.vpweb.com/

Survey of Medical Offices in Process

I am currently performing a survey in different cities around the country. Some of the questions being asked of medical offices will include their biggest challenges with preauthorization for advanced imaging. For example, how much time is spent doing prior authorizations and the type of training staff have received. It will be interesting to find out how wide spread the problem is and their opinion about how prior authorization will be affected if the public option is passed. Results will be posted to my website and blog. If you would like to participate in the survey, contact me via email at: consulting@rosewoodconsulting.vpweb.com
Thank you for all your support! Terri

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.

Free Consultation, No Obligation!

Contact me today for a free consultation with no obligation! Learn how your staff can be better trained to perform prior authorization for advanced imaging(MRI, CT, PET scan, nuclear medicine). Become a pro at providing a clear clinical picture to the nurse reviewer, decrease delay/denials, eliminate stress and frustration with the prior authorization process. My teleconference training is easy, affordable and will benefit your staff for years to come.
visit my website at http://www.rosewoodconsulting.biz/
or email me at consulting@rosewoodconsulting.vpweb.com

Another Reason Precertification Training for MRI, CT, PET, Nuclear Medicine studies is Important

As the healthcare reform debate continues, there is business as usual with primary insurance companies. They are still requiring precertification for advanced imaging studies. And staff are still struggling with the process.
Contact me today to discuss how my affordable and easy training program can teach you how to perform this task. It will make prior authorization easier and reduce staff frustration. Whatever happens with healthcare reform, you will be prepared. If the bill passes or not, insurance companies will still require prior authorization for advanced imaging. And if the bill does pass, insurance companies will be looking for ways to tighten their belt to compete with a governmental program, making prior authorization even more widespread. Having the proper training will allow you to meet the demands of obtaining precertification and give you peace of mind whatever may come.