Inconsistent payer rules are a major pain point for revenue cycles with direct clinical and financial impact on patients, according to Northwell Health's Christine Migliaro.
The prior authorization process is a well-known source of frustration for providers and a significant driver of administrative burden. In this HL Short, Christine Migliaro, vice president of front-end revenue cycle operations at Northwell Health, discusses the top challenges she encounters in the PA process. She outlines how a lack of standardization, staffing issues and slow payer response times create confusion and frustration for providers and patients alike.
Migliaro was a panelist during a recent HealthLeaders Revenue Cycle NOW Online Summit. Read more about the discussion or watch a recording of the full event here.
Luke Gale is the revenue cycle editor for HealthLeaders.
KEY TAKEAWAYS
Lack of standardized processes among for submission of prior authorization (PA) requests is a significant burden for revenue cycle leaders.
Slow response times to PA requests lead to delays in care and scheduling challenges for providers.
Increasing reliance on PA in the pharmacy space has affected access to prescribed medicines, which can lead to a lack of medication adherence.