Store all your Pre-authorization requests and responses in an easily accessible interface and monitor your Pre-auth requirement right from your Eligibility/benefits to make sure you do not render service and chase payors for retro authorization.
Analyzing the performance of a healthcare unit via easily comprehendible Bar charts, Pie charts, Line Charts, Density maps and meters gives a deep and clear understanding into the key performance indicators of any Hospital, Medical Practice or a Billing company.
The necessity whether a prior auth is required for a particular Procedure or service type or not, could be determined by verifying the benefits of that particular patient. This could be achieved by using the Eligibility Verification feature of the product “NellikkAI™”
When a prior authorization is found to be needed, a prescribed form with Procedure Codes and Diagnosis codes along with available Medical reports need to sent over to the respective Payor via a Fax or an EDI transaction or an API as applicable with each of the Payor. Currently majority of these Prior-authorizations were handled by fax only, and the Payor responds with a Prior-auth number or a denial.
Maintaining paper records of these Prior authorizations is a hassle and “NellikkAI™” is coming up with electronic transactions wherever it is possible. Nevertheless it has a Prior-auth request creation and Fax response module, where electronic requests could be created and sent over even fax automatically and stores/archives the responses for later retrieval by billing staff.
In essence NellikkAI™ uses electronic Fax and Email solutions to send out Prior authorization requests via a dedicated dial-out number and retrieves and stores the responses from the payors for future references; while it is ever adhering to better ways of communicating with the Payors as and when available.
