Developing benchmarks for your team is essential to ensure your tasks and projects are progressing as hoped. Here’s an example of how you could set up benchmarks for securing prior authorization benchmarks for your team.
Benchmark 1: Efficiency in Review time
- Objective: Decrease the time taken to review and complete prior approval forms.
- Action Plan: Improve the understanding of prior authorization request forms and specific insurer requirements.
- Evaluation: Measure the average time taken for a team to review and complete paperwork for various insurers before and after the training session.
Benchmark 2: Accuracy in Prior Authorization Requests
- Objective: Improve the accuracy of documentation and reduce errors in the prior authorization process.
- Action Plan: Develop or enhance templates for prior authorization, Conduct training sessions based on common errors.
- Evaluation: Track the number of requests that are rejected due to inaccurate or incomplete information and aim to reduce this number.
Benchmark 3: Streamlining the Communication
- Objective: Improve the interactions and communication between team, insurance companies, and physicians.
- Action Plan: Regular updates/meetings about the status of the cases, direct hotline for urgent cases.
- Evaluation: Monitor the satisfaction of administrators, physicians, and patients regarding the communication process.
Benchmark 4: Reducing Denial Rate
- Objective: Reduce the number of Denied/ Rejected prior authorization requests.
- Action Plan: Identify common reasons for denials, implement a checking process to ensure all necessary information is included.
- Evaluation: Measure the reduction in the number of denials/rejections over a specified timeframe.
Benchmark 5: Training and Updating
- Objective: Continually update team knowledge and understanding of changing insurers’ policies and regulations.
- Action Plan: Regular training sessions and updates to the team, timely analysis of the impact of changes.
- Evaluation: Assess the team’s understanding of the changes and their ability to apply them through quizzes, test cases, or evaluation of their work.
These benchmarks give a quantifiable way to measure improvements over time. Remember that every team’s specific targets will look different, depending on their specific circumstances and goals. These are only suggestions, and customized goals would give the best outcome. To read more about Healthcare, visit our website at www.mystaffology.com
