Pre-Authorization is one of the most complicated and time-consuming processes in the Revenue Cycle. If a provider doesn't have an efficient team to handle these complexities, it can tie down in-house resources and cause delays in inpatient care. This procedure is extremely disruptive, consumes time, and sometimes leads to rejection without any appropriate clinical review.

A faulty Prior Authorization process can lead to:

  • Delay inpatient care.
  • Claim denials due to invalid or no authorization.
  • Denial of payments due to incorrect use of codes ( CPT, Diagnosis, Revenue ) and modifiers.
  • Decrease in profits due to no or partial payments from the healthcare payer.
  • Failing to prove medical necessity where a prior authorization could not be obtained before the service.
  • MiraiCure back-office services include a complex prior approval process that involves gathering critical patient information and obtaining prior authorization approval from the concerned authorities, which prevents many unanticipated consequences afterward for both the patient and the practitioner.

Miraicure Advantage:

  • Error-free Authorization request submission on the same day.
  • Use of appropriate CPT, Diagnosis, and Revenue Codes along with suitable modifiers.
  • Timely follow-ups on submitted requests till it gets approved.
  • 100% HIPPA Compliant.
  • Turnaround time is 24 to 48 hours.
  • Increase patient satisfaction by reducing delay in inpatient care.
  • Cost reduction by up to 70%.
  • No binding contracts.