In addition to medication prescriptions, the diagnostic imaging, radiology and laboratory tests, treatment, procedures, equipment, supplies and other services physicians order most, which are closely managed by payers, are delivered ‘in network’ primarily by outpatient, sub-specialty and ancillary providers.
Benefits to the rendering, or ‘refer-to’, specialist or ancillary provider includes:
- Reduced intake, order/referral and prior authorization processing costs and FTE’s
- Reduced risks and delays in payment from unconfirmed authorization
- Support more accurate and transparent billing, and quicker bill payment
- Deliver preferred, provider-driven approach for utilization review & management
- Support capitated and ‘at risk’ contracts
- Reduced dependence on payment agents; potentially recoup lost profits
- Added value with new informatics and provider practice (IT) services
- New IT & service level extensions to practice systems, stakeholders, clients
- Enhanced patient experience, throughput and satisfaction
