Why Working PRN for insurance Companies Doesn’t Have to Be Soul Sucking

When physicians think about adding additional revenue streams to their practice, contracting with insurance companies is usually not top of the list. Processing claims and getting prior authorizations is arguably the most headache-inducing part of medicine.

Nonetheless, it is a revenue stream worthy of consideration for neurologists, especially during these lean times. It can be an easy work-from-home side gig that ultimately benefits your practice, says Todd Barnes, a neurology practice administrator in Oklahoma.

“They need PRN reviewers,” he says. “You can be independent, external. A lot of them have a need for that in their process of determining medical necessity or utilization review. All of this stuff can be done around your normal practice. And you kind of get to understand the other side. It gives some insight into the insurance industry that we all work with.”

Barnes also sees a shift happening in the industry where more specialists and subspecialists, like neurologists, are going to be needed.

On January 1, 2020, a new law reforming the preauthorization process went into effect in Kentucky. According to the American Medical Association, under this new law, “insurer [prior authorization] reviewers will be licensed physicians and, when possible, of the same specialty as the requesting physician.”

For neurologists, this means that when they talk to an insurance company to get the OK for a drug, test, or procedure, they won’t have to work as hard.

“[With] all the prior authorization stuff that we go through today, you end up talking to a pediatrician or a family practice doc, and you’re trying to explain to them the need for testing. You shouldn’t have to educate the person every time you’re talking to get a prior auth,” says Barnes.

This can be frustrating and often delays treatment, the problem this law is trying to eliminate. The law in Kentucky is the most recent, but Barnes says that there is similar legislation underway in other states and at the national level.

“Insurance companies are going to need more people in subspecialty or specialty roles that do some of this authorization work that they’re requiring,” he added.

What this amounts to is a growing work opportunity for neurologists. That work doesn’t have to be soul sucking. Barnes points to an interview with an internal medicine doctor doing this kind of work.

“I love working at home. I like my team. I like my superiors and the management structure of the company,” she is quoted as saying. “They take your concerns into consideration and try to make it work for you. The benefits and pay are really good. I enjoy getting to use my medical knowledge. It’s not a simple job, but there is so much less stress than when I was in clinical practice.”

Special thanks to Todd Barnes, MBA, Clinical Business Administrator Departments of Neurology/Neurosurgery at the University of Oklahoma Health Sciences Center in Oklahoma City, Oklahoma for his insights on this issue.

The post Why Working PRN for insurance Companies Doesn’t Have to Be Soul Sucking appeared first on Neurology Insights.

from Neurology Insights https://ift.tt/2Z8qOn9