When it comes to patient care, prior authorization challenges are one of the many roadblocks that stand between people getting the care they need. Studies have shown that 1 in 3 United States providers say that prior authorization processing delays have led to an adverse event for patients.
Prior authorization automation is a request from a provider to an insurance payer to obtain authorization to provide healthcare services. This helps insurance companies determine whether or not to cover a procedure, service, or medication and was designed to protect resources and save money. The process of submitting prior authorization can happen either manually or automated. Both of these processes are rigid and complex, leading to several side effects for everyone involved. For physicians, there are higher costs and increased administrative burden when prior authorization goes wrong. For patients, prior authorization can lead to delays in access, to care, or even hospitalization. Both patients and providers alike are worried about these disturbing new trends.
Luckily, there are new AI powered solutions that are tackling these challenges. These new systems have the power to save providers an average of 60% off all their existing costs. In addition to cost savings, these new solutions will improve patient experience, increase accuracy, and reduce dependency on staff labor.
Source: Orbit Healthcare
