Partha Nandi, MD, president and CMO of Pinnacle GI Partners, told Becker’s ASC Review how prior authorizations affect finances for the company and its ASCs.
Question: How much do you estimate prior authorization to affect revenue at your center?
Dr. Partha Nandi: For the total practice, at least 35 to 40 percent of revenue is affected overall, due to the fact that a majority of infusions require prior authorization, and at least a third of upper endoscopies and anesthesia now require authorizations.
For just the ASC facility charge, it would be considerably less, as it is just about one-third of upper endoscopies and very few colonoscopy procedures. I would estimate about 15 to 20 percent of revenue is affected in the ASC.
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