Authorization Challenges Related to COVID-19

by Brian Perry, DCI Software

For many provider agencies, managing authorizations can be tough under normal circumstances. While new and additional authorizations for service are a welcome response to the pandemic, and ensure that people will be healthy and safe, it can add undue administrative strain if your business management platform doesn’t provide the flexibility you need. This can add even more challenges to an already strained workforce. It is crucial that your organization be nimble and ready to adapt to these new challenges. You need to identify a few key pieces of information to start your journey.

Do you have a way to swiftly add and track new authorizations and service codes on the fly? How will you manage new authorizations and service codes during this time where most staff are remote? Who is tracking the authorizations utilization, and reporting on it? How can you maximize the authorizations you have to ensure cash flow is still coming in? These questions and hundreds of others like it are coming to light for an event none of us could have predicted. One key point in this is to take the time to refine your processes so you can come out the other side stronger and ready to get back to business as usual.   

It is imperative that you develop a system to maintain your authorizations, track remaining balances and be able to report on it in real time to know where you are succeeding and what areas could use improvement. The first is how to track your authorizations, this can be as manual as a spreadsheet, or by using a business management solution that is built for authorization management.

Whichever you choose, it is important to ensure you have procedures in place to gather all the authorization information you need, how accurate data is entered and tracked, and the necessary timelines to ensure you can start performing services for that authorization as soon as possible. You need to ensure you are tracking start, end and expiration dates for billing and compliance, and also that you have an easy way to update everything. As an agency you need to update your system regularly to ensure compliance and that you are utilizing your authorizations to their fullest, ensuring your clients are getting the support they need and deserve! Ideally you would have a business management system that you could use to track this information, and enforce any daily, weekly, or monthly authorization limits that apply. 

Once you have gathered your data, and are tracking it, is when you need to start monitoring and reacting to the trends you are seeing. Your agency should have a timely report you can review to determine what the status of any authorization is in real time. I have included a screenshot of the DCI Authorization Utilization Report. From this you can determine how best to proceed, to ensure your clients are getting the most out of their authorizations and your agency is creating cash flow during these tough times.

Having the ability to document, track and report against your authorizations is a key fundamental for a successful agency and once these processes are in place allow you to speed up your authorization onboarding and management so you and your staff can get back to caring for your clients or dealing with new circumstances surrounding the pandemic.

At DCI one of our key modules is the Authorization Management Module and it works with every other module in DCI to ensure that as time is recorded it subtracts from the authorization, driving compliance for your agency. It also links to any training requirements for an authorization to be sure they are met prior to services being provided. All these add up to a business management platform that provides an agency with an easy to use system, that gives you power over your data to be able to enact change over your organization and provide better care to your clients. For any questions about authorization management, in general or DCI, please contact us at www.DCISoftware.com or [email protected].

Brian Perry is the Vice President of Sales for Direct Care Innovations. Brian has 15 years of sales and sales management experience and 9 years healthcare IT experience managing teams of sales executives and project managers.