Disruptive technologies and innovations in business strategy are constantly changing the real-time dimensions of the healthcare industry in all aspects. Today, leading providers as well as payors are looking for cutting-edge business models that will augment their business growth. Prior Authorization services are often regarded as the fundamental pedestal that influences the financial health of a practice. Enabling the right checks & balances is an essential aspect that needs better consultative aptitude for effective up gradation.
Challenges with the paper process!
It is true that studies have revealed that using paper in prior authorization often delays the patient-centric model.
♦ It is seen that almost 70% of the patients do not receive the exact treatment that their provider ordered originally!
♦ In-house staff spend 20 hours per week and even more completing the hassles with paper work on authorization services.
Momentum on digital efficiency!
Medication processes in healthcare are becoming digital and providing the necessary automation.
♦ The new features that are available these days in EMR are preventing useless communications between the insurer’s plans & the pharmacies.
♦ Automated generation of the task list with comprehensive forms on prior authorization is providing additional value.
How do you start the process electronically?
In order to expedite the process, the pharmacies that you are connected with will deliver requests on authorizations electronically much similar to the process of refilling the requests. The synchronized attempt will facilitate you receiving timely notifications via phone or fax by the pharmacies with overdue intimations.
Electronic submissions will assist you:
♦ Saving time with populated categories in forms that are updated with patient information as well as practice details from the EMR to accelerate the verification process
♦ Effective tracking of the status on prior authorization after their submission
♦ Making your practice improve their medication attention with reduction in prescription hold-ups.
Most importantly – insights improving transparency!
The key benefits will be:
♦ You have to be verified with e-prescribe with formulary enablement helping EMR check the plan coverage automatically
♦ The prescriber will be notified automatically with the system auto-generated notification about a prescription that needs prior-authorization
♦ The notification will generate a new task for Prior authorization in the tasks segment that has to be reassigned for completion at a TAT of 24 hours!
The electronic process will provide the right streamlining with improved dimensions implementing a comprehensive methodology in eligibility verification services.