JP Bader

Case Study: Patient wants straightforward care, doctor fails to deliver!

On a recent visit to his doctor, Joe (a patient) checked in to see his doctor about severe back pains he was experiencing. He was quite impressed that he could schedule his appointment online, and that his reception check-in was done via on an iPad. Joe is a busy person, and was happy to see how technology is being implemented in the doctor’s office.

Over the last 20 years, advertisements and commercials make a lot of claims about the improvement of healthcare through the use of technology. Joe started to feel like he was now living in the future! Even during the examination, Joe even remarked at how great it is to have an EMR to track all the patient history, and how much better it is than paper records.

After a thorough examination, Joe left the office with understanding he needed an MRI. Joe was looking for relief and hoped the MRI could explain the problem. The doctor assured Joe that his office would handle the paperwork and send everything to their radiology clinic(the practice and clinic are both part of the same hospital system).

After a few agonizing days, Joe called the radiology clinic because he was in pain and no one had called about an appointment. The clinic, to his dismay, never received the paperwork! Joe immediately called the doctor’s office, and discovered that the office had not yet done anything!!!

The person who coordinates MRIs needed to get the order pre-authorized through Joe’s insurance. However that coordinator was too busy. Joe’s doctor wouldn’t proceed with any treatment until he got the MRI results and yet the doctor’s staff was too busy to handle this .

Joe was in pain and upset. His doctor was part of a large practice whose advertising and marketing material kept talking about providing more responsive care. All Joe wanted was to get better. The doctor and his staff needed to sort this out but they weren’t all on the same page.

Many of our clients’ patients described this exact scenario. There are a lot of clinics that have internal staff do pre-authorizations as part of their normal routine. However there are two problems: the 1st is scheduling - patients aren’t involved in the process (no communication to let them know if there are any delays or denials), and 2nd medical office staff are dealing with a burdensome administrative process created by insurance companies. And the solutions implemented by most offices are inefficient and cannot scale to meet rising needs. Pre-Authorizations are part of the new world order, and the myriad tasks associated with Pre-Authorizations cause big headaches for doctors, their patients, and service providers.

Does this sound familiar?


Next Health Choice offers a solution to ease this administrative dilemma. Our single-entry workflow allows you to simply provide the required information, and our automated workflow handles everything else. We offer eligibility verification and pre-authorization services. Next Health Choice is a scalable service that means your staff can focus on other pressing duties, get back to providing good care to your patients, all while you can save time and money on these administrative tasks.

Next Health Choice: Taking Pain Out of Pre-Auth!


More patient time, less office work

Get in touch with Next Health Choice today to learn more.

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