If you’ve spent any length of time at a healthcare provider’s office, you’ve likely heard the term “prior authorization”. The term refers to a healthcare provider requesting authorization from an insurance payer for specific services. While this was intended to protect the insurance company’s resources, requiring an approval for most procedures has created a tight bottleneck. Worst of all, this bottleneck has led to significantly delayed access to care.
Based on 1,000 healthcare providers, it’s estimated that while waiting for prior authorizations, 25% of patients experience hospitalization. Furthermore, 19% experience a life-threatening event and 9% experience a permanent bodily injury, including disability and even death. While there are large processing delays with the insurance companies, the traditional process to complete prior authorizations can be quite arduous.
Fortunately, modern technology has heralded a new solution in the form of AI-powered prior authorization process automation. With automated prior authorization workflows, the process of retrieving medical records, filling out prior authorizations, and checking the status is greatly expedited. Not only does it save time, but it’s estimated to save 60% of existing provider costs as well. Regardless of who your business serves, you can save yourself both time and money with automated prior authorization systems.
Source: Orbit Healthcare