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Myndshft Blog

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January 16, 2023

How Prior Authorization Software Takes Your Patients’ Intake Experiences to a New (Nicer) Place

by Susan Lawson-Dawson | Prior Authorization

The transition from patients to healthcare consumers has been underway for a while, but in the wake of the pandemic, the process accelerated. By the end of 2021, the tide had shifted in favor of consumerism. Reporting on a survey by healthcare experience analytics firm Press Ganey, Forbes noted that results revealed “… the ascendance of consumer shopping behavior—and its potential importance to healthcare providers.” Adopting digital solutions like prior authorization software can help to set the right tone from the start. But first, let’s take a look at why and how patient expectations have changed. 

Providers face a higher bar for healthcare delivery

When it comes to the most-loved brands, organizations that earn top marks typically hit three experience metrics: convenience, affordability, and personalization. Take perennial favorite, Amazon. FounderJeff Bezos said early on, “If there’s one reason we have done better than our peers in the internet space over the last six years, it is because we have focused like a laser on customer experience.” 

Healthcare providers, on the other hand, have long emphasized quality of diagnosis and treatment over patient experiences. That’s changing, and not just because of healthcare consumerism. As powerful new competitors like Amazon and Walmart enter the healthcare scene, they bring with them mature digital capabilities and consumer insights that providers lack. As a result, a Deloitte-Scottsdale Institute survey found that 92% of providers say that the #1 goal of their digital transformation initiatives is to increase consumer satisfaction and engagement. 

Patients want smooth experiences, not prior authorization hurdles

Havard Business Review points out that “Health systems are only belatedly recognizing the need to provide great medical care and a terrific consumer experience—that performing poorly in one role will impact performance in the other.”  As we transition to value-based care, positive experiences that fuel engagement will become even more critical. The best care plan in the world won’t deliver results if the patient remains disconnected and unmotivated because of a poor experience. 

The importance of a positive experience becomes clear when you realize that healthcare provider review sites have seen 54% increase in usage since 2019. 

  • 57% of Baby Boomers and 45% of Gen Z and Millennials say they have submitted an online review of a healthcare provider. 
  • 59% of healthcare consumers say they look for a four-star average rating or higher when choosing a provider. 
  • 84% also say they would be unlikely to see a provider with less than four starts, even if it was a referral from another provider.

With so much riding on the experience side of the equation, healthcare providers have turned to technology adoption. Online portals for scheduling appointments and accessing healthcare information are commonplace now. But patient satisfaction is a mercurial beast; when something like prior authorization slows the patient journey, patient satisfaction takes a hit too. 

Streamline patient experiences with prior authorization software

What does end-to-end prior authorization look like? It starts with facilitating data exchange— payers’ plans and policies, providers’ clinical documentation, and patients’ health and benefits information. That’s what Myndhsft calls Collective Healthcare Intelligence™and when it’s combined with intelligent automation, the result is an efficient process that frees staff and clinicians from burdensome paperwork and connects patients to the treatments, services and medications they need, sooner. 

  • Real-time eligibility and benefits verification is automated, relieving staff of time-consuming phone calls to payers or digging through payer web portals and clearinghouses.  Benefits: Saves time and boosts staff productivity.
  • Insurance discovery identifies third-party payers the patient may have missed or forgotten. Benefits:  Adds value for the patient and improves provider reimbursement rates.
  • Patient financial responsibility calculation uses the patient’s benefits information, including co-pays and deductibles. Benefits: Delivers price transparency at the point of care which contributes to higher patient satisfaction and improves provider reimbursement rates.
  • Prior authorization requirements and submission automates one of the most burdensome administrative tasks providers face, gathering the relevant information and pre-screening the submission for errors and medical necessity before submitting it directly to the payer. Benefits: Reduces the need to rework claims up to 90%, eliminating preventable delays that detract from patient experiences.

Healthcare may be lagging behind other industries in terms of digital transformation, but with patient satisfaction and engagement a top-of-mind concern in 2023,  providers will be running hard and fast to catch up. Arrange a personalized demo to see how Myndshft prior authorization software can help.