If you’ve worked in a doctor’s office, you know the struggle of completing prior authorizations. Prior authorizations are requests from a provider to a health plan to obtain authorization for healthcare services. Originally, prior authorization was meant to protect the insurance companies’ resources and save money. Unfortunately, needing approval for most procedures has bottlenecked healthcare services and 1 in 3 providers say this bottleneck has led to adverse patient outcomes. But how can modern technology help solve this problem for healthcare providers?

Traditionally, the process of prior authorizations involves around 6 steps. Firstly, the patients’ details must be manually checked, then the medical charts and documents, and then the prior authorization requests are submitted through fax and portal. This process alone can take anywhere from 15-20 minutes per patient, but then the administrative worker must also check up on this request constantly. Even worse, if this claim is denied, the entire process must happen again with an appeal letter as well. Finally, when the claim is accepted, it must be updated in the patient documents.

Fortunately, with prior authorization process automation technology like Orbit AI, patient information is gathered automatically and then it checks to see whether the prior authorization is necessary. Next, it automatically fills out the prior authorization request and continually checks on the status of the request through the appropriate portal. Finally, once a request is approved, Orbit automatically updates medical records to save all the hassle from administrative staff.

While it’s clearly beneficial, the true advantages cannot go ignored. Through a traditional method, every manual authorization costs around $11 and 20 minutes of time and effort. Because of this 93% of physicians say prior authorizations leave them with a high administrative burden and 35% of healthcare providers hire staff solely to work on prior authorizations. Similarly, 3 in 4 doctors say their denials have increased significantly over the past 5 years and 27% of physicians say their prior authorizations are always denied. Even though it can lead to adverse patient outcomes, nearly half of all healthcare providers don’t have the time, staff, or resources to pursue these appeals.

However, when you introduce automated authorization systems, healthcare providers can fully automate prior authorization by up to 82% or more and save an average of 60% of all their existing costs. Instead of spending $11 per prior authorization request, as much as $9.60 can be chipped off through Orbit AI. Rather than spending 20 minutes of time and effort, these automated systems take less than 5 minutes to fully complete the request. On top of all that, automation solutions complete medical documents without the possibility of human error and save 12 hours a week per staff member. This all culminates in a better experience for your patients and better patient outcomes.

Ultimately, regardless of what type of healthcare you provide to your patients, you can save both time and money with automation solutions. To help your staff get back to helping your patients, take advantage of prior authorization automated solutions.

Source: Orbit Healthcare