As healthcare continues its value-based care (VBC) journey, the need to optimize inefficient administrative processes remains acute. Prior authorization software offers a clear path, helping providers cut through the time-consuming maze of manual efforts with a streamlined, automated process. How does leveraging a unified platform for medical and pharmacy prior authorizations support value-based care? Pandemic a catalyst for VBC momentum Unlike traditional fee-for-service (FFS) models, value-based care focuses on patient outcomes and rewards healthcare providers for efficiency and effectiveness. And, based on new data recently reported by RevCycle Intelligence, adoption of VBC models is climbing. The article notes, “Over half… Read entire article here
What is the biggest bottleneck in healthcare delivery? Over the years, prior authorization has earned its reputation as a barrier to care. Despite being intended as a measure to ensure the most effective and cost-efficient treatment, the typical manual prior authorization process often has the opposite effect. A recent Mayo Clinic article, for example, looks at the impact of the prior authorization process on gastroenterologists and patients with inflammatory bowel disease (IBD). Research findings suggest that savings evaporate in the face of care delays that contribute to declining health and subsequently more utilization. One of the study’s co-authors, Dr. Francis… Read entire article here
Dealing with prior authorizations compares to navigating a labyrinth—complex, frustrating, and time-consuming. Created to ensure the optimal use of healthcare resources and minimize unnecessary expenses, these authorizations come in two flavors: medical and pharma. What differentiates the two, and why should you care? As the regulatory landscape around interoperability, prior authorizations, and pharmacy benefit managers (PBMs) continues to evolve, integrated prior authorization software offers a robust solution now and into the future. What distinguishes medical prior auth from pharma prior auth? Medical prior authorizations pertain to the pre-approval necessary for various healthcare services like surgeries, diagnostic tests, or medical equipment.… Read entire article here
October 20, 2023
Gain a Competitive Edge: Up Your Value for Customers With Automated Medical & Pharmacy Prior Authorization Software
by Susan Lawson-Dawson | Healthcare Technology
It’s no secret that in the hyper-competitive healthcare technology landscape, software-as-a-service (SaaS) providers need to adapt fast to customer needs or risk losing them to more agile and innovative competitors. As the need to streamline administrative processes in healthcare grows, so does demand for integrated solutions. Automated medical and pharmacy prior authorization simplifies one of the most notoriously time-intensive tasks your customers face. And no matter how agile your development team is, the complexity of prior authorization means you’re looking at a huge investment of time and resources. Oh, and by the way, your customers wanted easier prior authorizations yesterday. … Read entire article here
