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Myndshft Blog

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April 21, 2022

Automating the Prior Authorization Process

by Developer | Healthcare Administration, Healthcare Technology

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Prior authorizations were created, in theory, to reduce the amount of unnecessary or redundant medical treatments, and therefore cut costs and improve patient safety. But in practice, the benefits of prior authorizations have only served to increase the cost for providers. Mention prior authorizations in a room full of physicians and you’re likely to see a fairly animated reaction.

According to the Journal of the American Board of Family Medicine, prior authorizations cost the healthcare industry between $23 and $31 Billion each year and the American Medical Association found that the only other measure that physicians rated lower was patient cost sharing. Despite the best intentions these very tedious and manual authorization processes tie down medical staff to paperwork instead of allowing them to focus on quality patient care. So, what can be done to make this very necessary process less tedious for patients and providers? Enter process automation.

Thanks to significant improvements in cognitive computing and improved technology, prior authorizations that used to require time-consuming manual paperwork can now be completed as simply as the click of a button. With automation providers are able to:

  • Check patient eligibility
  • Submit request for prior authorization
  • Send automated approval notices
  • Facilitate payer-provider collaboration
  • Automate referral of approval requests
  • Comply with the requirements of each payer

…and much more.

Automation streamlines the prior authorization process for all parties involved. Automation simplifies the process and increases the level of accuracy which, in turn, provides a faster turnaround time for approvals. These quicker turnaround times results in cost savings for the payer and provider and a better patient experience and timeliness of care.

Across the healthcare spectrum process automation has huge potential to impact the growth in the costs of healthcare.  Combined with artificial intelligence allows payers and providers to focus on providing patient care while also gaining valuable insights into the myriad challenges posed from a complex industry structure and regulatory environment.

Find out how Myndshft’s M:IA™ for Healthcare can help you streamline your revenue cycle processes with Intelligent Process Automation. Simpler. Faster. For Anyone.