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Authorization Management

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Authorization Management

Part of the impact of the Affordable Care Act (ACA) is to place an increased emphasis on pre-authorization and verification of eligibility for specific procedures and charges. Patient responsibility has changed, and services that are performed without specific authorization can cause significant business challenges downstream in the process such as rework, payment delays, a decrease in patient satisfaction, an increase in errors and general nonpayment of service charges. Customers are more willing to pay additional charges upfront when they are aware of them, so the management of authorization and pre-certification are receiving a great deal of scrutiny.

Novigo provides customers with a broad mix of technology, staff, management, process improvement and quality initiatives that serve to deliver the most cost-effective and high-quality patient insurance eligibility data that will help you reduce Accounts Receivable cycles and increase your cash collections through a reduction in denials and write-offs. Eligibility can be determined by a number of different methods, including email, fax or EDI, Navinet, Emdeon and payer websites like Optum, Cigna, Value Options, Magnacare, Palmatto GBA, Medicaid, as well as offering automated voice response systems and direct phone calls.

We can work with you directly to obtain pre-certification data, update patient information and demographics, process enrollments – all determined by your unique business needs. Just because bad debt and patient liability are on the rise, that doesn’t mean that your business should be negatively impacted. Let us work with you to define business practices that will ensure your costs stay low and revenue and patient satisfaction stay high.

  • Authorization data entry

  • Authorization data entry

  • Authorization status update