As patient volume grows, many specialty practices struggle to keep up with the administrative demands of prior authorization. A sleep medicine practice in Vancouver, facing a shortage of experienced billing staff, has turned to SunKnowledge's dedicated Full-Time Equivalent (FTE) model to manage prior authorization for sleep studies and PAP therapy programs.
The practice had been handling prior authorization for polysomnography (PSG), home sleep apnea testing (HSAT), and CPAP/BiPAP therapy with a small internal team. However, as the number of patients increased, the practice found it difficult to hire and retain staff with the necessary expertise in sleep medicine authorization. This resulted in empty testing slots and delayed treatment for patients.
Rather than continue competing for scarce billing talent, the practice chose to bring in a dedicated specialist through SunKnowledge's FTE model. This approach provides the practice with an experienced, sleep-medicine-trained specialist who works as an extension of their team, without the time and cost associated with recruiting and training new in-house staff.
According to Ronnie Hastings, spokesperson for SunKnowledge, "Staffing shortages are one of the most common reasons sleep medicine practices reach out to us. Finding and keeping people who understand both payer requirements and sleep medicine workflows is difficult right now. Our FTE model gives practices that expertise immediately, without asking them to go through another hiring cycle."
Under the arrangement, SunKnowledge's dedicated specialist manages the practice's prior authorization workload end to end. This includes reviewing physician documentation, preparing and submitting requests, following up with insurance companies, responding to requests for additional information, tracking every pending case, managing reauthorizations, and handling appeals when a request is denied.
Because the same specialist works with the practice every day, the arrangement is designed to function more efficiently than a shared billing team. Over time, the specialist becomes familiar with the practice's documentation standards, payer mix, and scheduling process, reducing the back-and-forth that comes with explaining the same details to different people each time.
The partnership reflects a broader pattern SunKnowledge has seen across sleep medicine. As home sleep apnea testing expands and PAP therapy programs grow, many practices are finding it harder to staff their authorization workflow internally, even as payer documentation requirements continue to increase. For practices in competitive labor markets, a dedicated outside specialist can be faster to bring on than a new hire and comes already trained on sleep medicine's specific authorization requirements.
Practices that start with a single dedicated FTE often expand the arrangement as volume grows, adding specialists to cover additional authorization work without having to recruit and train each new hire themselves.
Beyond sleep medicine, SunKnowledge provides AR, claims management, and complete revenue cycle management support across a range of specialties, helping practices manage payer requirements without expanding their internal teams.
