JP Bader

Case Study: What happens when patients get the unexpected expediency.

Karen was training for a half marathon. While out running and twisted her knee. Karen iced her knee overnight, but the pain did not gone down so she made an appointment the next day to have it checked. Her physician said she would first get an x-ray to rule out anything was broken, however Karen would most likely also need an MRI. Her doctor suspected a torn meniscus, but wasn’t sure quite sure if it was serious enough to need surgery. After her x-ray, Karen’s doctor tells her the x-ray was inconclusive, so Karen gets an order for an MRI. As Karen checked out from her doctor’s appointment, she was handed a copy of her MRI order, but she was told to hold off scheduling the appointment until her doctor’s office received authorization (if needed) from her insurance company. Once they confirmed with her insurance company Karen would be able to schedule her MRI.

While Karen was checking out, one of the medical assistants reviewed the doctor’s order and had quickly submitted the MRI order through Next Health Choice for Pre-Authorization, then moved on to their next task.

After leaving, Karen was eager to schedule the exam but told herself to wait until tomorrow afternoon. If she did not hear anything about her insurance, she would call to schedule the exam anyway. She knows how paperwork can be forgotten or missed, and her soreness, anxiety, and overall stress kept pushing her to make sure she could get an appointment in the next few days. She told herself to maybe just book it for a few days out. That should give her doctor enough time to get the paperwork done. Karen set a reminder for the early afternoon to call and schedule her MRI, just in case.

Later that morning, while Karen was in a team meeting at her office, she received a voicemail. Her MRI was Pre-Authorized and all information was already sent to the imaging center. All she had to do was call number and schedule the exam. As luck would have it, the imaging center had a last minute cancelation for that evening. Since the imaging center already had her paperwork, they had no problem scheduling her for a same day appointment. And to top it off, because the imaging center had her paperwork, they also had her order, so even less to carry and worry about!

Karen received her results the next day and was relieved to learn she did not need surgery. The whole diagnosis process was so effortless she took the time to write positive reviews of both her doctor and the imaging center online.

Don’t let insurance stand in the way of a good patient experience

Doctor’s offices and medical groups often cannot control barriers created by insurance companies. However they do not have to be powerless either. Every patient interaction can be as effortless as it was for Karen with a little help from Next Health Choice. We streamline the process and maintain communication so that complicated insurance processes will no longer be a concern for your office or your patients.


More patient time, less office work

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

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