The revenue cycle is the financial heartbeat of any healthcare organization. It encompasses both administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue. At the core of this complex cycle is prior authorization—traditionally a time-consuming and often frustrating process. Automated prior authorization technology represents an opportunity to unlock new revenue potential. Keep reading to see how automation revolutionizes revenue cycle management (RCM) by streamlining prior authorizations and reducing preventable errors that lead to revenue cycle-busting delays and denials. The bottlenecks in traditional prior authorizations Traditionally, prior authorization has created RCM gridlock due to:… Read entire article here
November 27, 2023
Sight-Saving Technology: The Role of Prior Authorization Automation in Vision Care
by Susan Lawson-Dawson | News
As we step into December, recognized globally as the Gift of Sight Month, we’re shining a spotlight on how advancements in healthcare administration, particularly in automated prior authorizations, brighten the prospects for patients at risk of sight-related health issues and the providers who care for them. The vital link between eye health & prior authorizations Eye conditions, ranging from diabetic retinopathy to glaucoma, can escalate rapidly, turning from minor issues into sight-threatening emergencies. In fact, untreated diabetic retinopathy increases the risk of blindness 25X compared to non-diabetics. Timely access to treatment is not just beneficial for these patients; it's critical.… 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 | News
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
September 27, 2023
Tackling the PBM Dilemma: Is Automated Pharma Prior Auth the Answer to Healthcare Complexity?
by Susan Lawson-Dawson | News
Last year, the Federal Trade Commission (FTC) announced an investigation into the business practices of Pharmacy Benefit Managers (PBMs), beginning with the six largest ones in the U.S. This year, the U.S. The House Oversight and Accountability Committee launched its own inquiry into PBMs. Why are they under so much scrutiny? While PBMs get described as integral to the U.S. healthcare landscape, a growing number of healthcare stakeholders are raising critical questions about added complexity, higher costs, and patient impact. Let’s explore the factors leading many to reevaluate the role PBMs play in our healthcare system and how pharma prior… Read entire article here
