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Myndshft Blog

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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.  If your health IT solution currently doesn’t address this pain point, you might be missing out on a significant opportunity to offer added value to your clients.  

Your customers are desperate for automated medical and pharmacy prior authorization  

Prior authorization remains a serious sticking point for providers.  According to the AMA, 88% of physicians rank the prior authorization burden as ‘high’ or ‘extremely’ high. In fact, the average clinician in a medical practice spends about 2 days a week on prior auth paperwork—and that’s just an average volume of 45 prior authorizations a week. In high-volume, fast-turnover healthcare facilities, those numbers escalate rapidly. 

All this wasted time on administrative work leaves clinicians frustrated and burned out. They didn’t choose healthcare careers to become desk jockeys. They want to make a difference for patients. And unfortunately, in addition to reporting that they have less time for direct patient care due to paperwork, four in five physicians also contend that burdensome prior authorization requirements lead to higher overall utilization, resulting in waste rather than cost-savings that prior authorizations were intended to provide. 

  • 64% say patients are pushed into less effective initial treatments like step therapy
  • 62% say patients need additional office visits due to prior auth policies
  • 46% say delays or denials contribute to urgent or emergency care visits

Patients end up paying more while health outcomes actually worsen.  Is it any wonder that your healthcare provider customers want a solution? 

Deliver what your users wantsoonerwith a prior authorization software integration

By integrating prior auth software into your existing health IT solution, you can bypass these issues. Such integration gives your users added value by: 

  • Streamlining Processes: Automated requests and responses can significantly reduce the time spent obtaining authorizations.
  • Reducing Preventable Errors: With fewer manual touchpoints, the risk of miscommunication or data-entry errors diminishes, as does the need to rework denials.
  • Increasing Client Satisfaction: Healthcare providers you serve can focus more on patient care and less on administrative burdens, building loyalty among your users. 

By offering a solution to a critical pain point,  your platform caters to real-world demand and positions itself as a front-runner in the market. Building a prior auth software from scratch can be resource-intensive, both in terms of time, resources and finances. Not to mention, it comes with its own set of challenges, from ensuring regulatory compliance to troubleshooting inevitable bugs. Opting for a prior auth software integration allows your business to leapfrog these challenges. By leveraging existing, proven software, you can provide clients with a robust solution, minus the developmental headaches.

Differentiate from the competition with in-demand capabilities

In the crowded marketplace of health IT providers, differentiation is key. While many platforms offer electronic health records, billing, or practice management tools, far fewer include advanced features of a prior auth software integration. The reason?  More than 1,000 payers, each with their own plans and policies, makes building an automated system hard enough. Add in the constant payer changes, different processes depending on whether the therapy or service falls under medical or pharmacy benefits, and you begin to see why a partner with a singular focus on prior authorization automation beats building it from scratch. 

Future-proof your SaaS with a medical and pharmacy prior authorization integration

As healthcare continues the inevitable path towards increased automation and interconnectivity, integrated solutions will become the norm, not the exception. By integrating prior auth software now, you’re not only meeting current demand but also preempting future expectations. Make a strategic move to stay relevant, competitive, and responsive to client needs. While the initial integration might require investment, the long-term returns in client satisfaction, reduced churn, and increased market share are well worth the effort.

See how Myndshft can help. Let’s talk!