SSI Prior Authorization
Enterprise-wide end-to-end prior authorization that includes infusion, physical, occupational, and speech therapies (anything covered under medical benefits)
Solution Highlights
700 real-time payer connections
Covers anything under medical benefits
Reduces the complexity, costs, and time crunch of a manual process
End-to-end automation that takes seconds to complete
Reduce prior authorization denials and get ahead of CMS regulations
According to the latest SSI data, prior authorization (PA) denials have increased 50.3% since 2022. Furthermore, of all 2022 CAQH Index-tracked administrative functions, PA is the most time-consuming transaction for providers.
With upcoming CMS regulations requiring an electronic solution by 2026 for incentive payments, now is the time to get ahead by implementing the right automated prior authorization solution.
SSI Prior Authorization can put you on the right path, reducing denials and ending the time-consuming detective work necessary by automating the process from end to end. It can also help reduce the time required to complete existing PA workflows by 90%!
Watch this brief demo to learn about SSI Prior Authorization – our end-to-end automated prior authorization (PA) solution for hospitals and health systems that provides enterprise–wide improvements.
Have 5 minutes? Watch the demo to see what SSI Prior Auth can do.
Reduce the complexity and costs of your prior authorization process with SSI Prior Authorization.
real-time payer connections
%
of covered US patients
%
reduction in authorization cycle time
%
less claims rework
How It Works
STEP 1: Determines if PA is required and sources appropriate submission form
SSI Prior Authorization powered by Myndshft includes a proprietary Payer Rules Engine and Policy Library that identifies PA requirements based on the payer, plan, and CPT or HCPCS codes provided.
- Connects in real-time to 700 payers covering 94% of covered US patients
- Synchronizes eligibility and PA rules for continuously up-to-date information
- Uses patients’ payer, plan, service type, place of service, diagnosis and clinical data to improve the accuracy of PA determinations
STEP 2: Pre-screens PA submissions for errors and medical necessity
- Automatically checks the request for errors and missing information
- Supports PDF uploads of signed physician orders, medical history, and other documentation
- Eliminates double entry, reducing the likelihood of human error and preventable denials
STEP 3: Submits PA request directly to the payer
- Uses each payer’s preferred submission method, i.e., fax, payer portal, or EDI 278 transaction
- Generates a time-stamped submission ID for easy status tracking
STEP 4: Monitors PA request statuses
Features & Benefits:
Hands-Free Prior Authorizations
- Pre-checks for errors, missing information, and medical necessity
- Submits PA request via each payer’s preferred submission path
- Monitors status of all PA requests in one convenient location
- Boosts productivity by automating repetitive, error-prone manual tasks
- Reduces expenses by preventing avoidable denials and operational inefficiencies
Enhance Patient Experience
- Significantly decreases patient’s time to care
- Reduces the need to reschedule or delay patient treatments
- Frees staff to increase capacity or reallocate to more patient-centric, high-value tasks
Request A Prior Authorization Demo
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Make your move toward stronger financial performance.
