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
Prior authorization for pharmaceuticals is a critical yet often complex and time-consuming process. Healthcare providers and pharmacists face off against a maze of requirements that differ from one pharmacy benefit manager (PBM) or payer to another. This can not only delay patient treatment but also piles on administrative overhead. As a result, choosing the right pharma prior authorization helps you optimize performance to reduce operational expenses while enhancing patient care. Here’s what you need to know. Pharma prior auth more prevalent than ever Specialty medications increasingly capture a larger slice of drug spending in the US. These complex drugs often… Read entire article here
In the ever-evolving realm of healthcare, oncology stands out as a field that requires prompt, precise, and above all, compassionate care. Every procedure, medication, or therapeutic session can be pivotal in a patient's battle against cancer. And herein lies the challenge: How do you ensure that potentially life-altering treatments earn prompt approval, reducing gaps in patients’ care journeys and in your revenue cycle simultaneously? Addressing process inefficiencies with prior authorization automation makes a huge difference. After all, prior authorization doesn’t just result in an approval or denial for patient care. It also confirms a payer’s commitment to reimburse you for… Read entire article here
October 4, 2023
Rebates, Discounts, and Formularies: How PBMs Shape Medication Access & the Benefits of Automating Prior Authorizations for Pharma and Medical Benefits
by Susan Lawson-Dawson | Healthcare Technology, Prior Authorization
As professionals deeply involved in patient care, understanding the complex dynamics of medication access represents a pivotal aspect of your role. Prescription medications are often the cornerstone of treating numerous health conditions, but how these medications are priced, accessed, and distributed can be enigmatic, to say the least. Some medications fall under medical benefits, such as injection or infusions of biologics for rheumatoid arthritis. Others, those self-administered by the patient, fall under pharmacy benefits. That’s where Pharmacy Benefit Managers (PBMs) enter the picture. This adds yet another layer to the already complicated world of prior authorizations, which often serves as… Read entire article here
