For healthcare providers, prior authorization automation requests can be a burdensome task for their administrative staff. Staff have to check patient details, read medical records, manually submit the request via fax or online portal, and then continually follow up with the provider for status. Even worse, if the request gets denied, they must do it all over again with an appeal letter and more documentation. All the while, the patient is suffering, and outcomes are liable to become worse during this delay. So how can we help to make this process as fast as possible?
Currently, around 70% of prior authorization is done manually, which can quickly cost hundreds of man-hours alone annually. In fact, every manual authorization request costs $11 and 20 minutes. Simultaneously, a quarter of physicians claim their requests are always denied and the approval criteria are incredibly vague, which means that appeal is a frequent and burdensome phenomenon for the administrative team.
Fortunately, new AI systems can make it easier for these healthcare providers. These systems can automatically retrieve patient information, then confirm the necessity of prior authorization requests, and fill out the needed documentation. After this, the prior authorization request is then submitted and then continually monitors the status of the administrative team. These systems help save time and money for both you and your clients.
Source: Orbit Healthcare
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