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Tag: automated prior authorization

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March 30, 2023

Game Changer Alert: Automated Prior Authorization Leaves Electronic Methods in the Dust

by Susan Lawson-Dawson | Prior Authorization

Public payers—Medicare, Medicare Advantage , Medicaid, and the Children's Health Insurance Program—provide healthcare coverage for members that qualify based on income, age, special needs factors. Private payers like Aetna, Blue Cross Blue Shield, Cigna and hundreds of others offer health insurance coverage through employee-sponsored plans as well as individual plans marketed directly to consumers by individual payers or through the healthcare.gov marketplace. And every single one of them uses prior authorization to manage utilization and reduce costs.  Unfortunately, the current prior authorization process requires a lot of manual effort, sometimes helped along with electronic prior authorization (ePA). But it’s a… Read entire article here

March 14, 2023

Myndshft Advocates for Da Vinci Standards in Public Comments to CMS Proposed Prior Authorization Rule

by Susan Lawson-Dawson | News

The public comment period just closed for the Centers for Medicare and Medicaid Services’ (CMS) proposed rule on “Advancing Interoperability and Improving Prior Authorization Processes.” And as of 11:59 PM March 13, the CMS had received close to 1,000 comments, including one from Myndshft. Below is a quick recap of our response.  Want more details? Check out our Myndshft response to the CMS request for public comment in its entirety.  Addressing prior authorization crucial for value-based care success Rampant process inefficiencies slow progress toward value-based care. Today’s manual prior authorization process is time-intensive and costly, and that won’t change without… Read entire article here

February 22, 2023

How Does Prior Authorization Software Help Reduce Physician and Member Abrasion?

by Susan Lawson-Dawson | Healthcare Technology, Prior Authorization

Late last year, Fierce Healthcare noted that “...nearly a third of healthcare resources are tied up in administrative costs, taking focus away from patient care.”  The research, published by Health Affairs in 2018, reveals that billing complexity remains a source of payer-provider abrasion that must be addressed. If you want to uncomplicate the path to timely patient care, prior authorization software can help.  3 Factors that Contribute to Physician and Member Abrasion Dealing with healthcare payers—whether as a provider or a member—often results in frustration. What are the biggest hurdles to more satisfying (or at least, less irritating) experiences?  Complex… Read entire article here

January 30, 2023

Must-Read Advice Before You Select a Prior Authorization Software Partner

by Susan Lawson-Dawson | Healthcare Technology, Prior Authorization

Charles Darwin, father of the theory of evolution, wrote, “It is not the strongest of the species that survives, nor the most intelligent, but the one most responsive to change.” While he may have been talking about flora and fauna, Darwin’s theory seems quite relevant to Software as a Service (SaaS) providers in today’s rapidly-evolving healthcare landscape. Integrating prior authorization software in your existing solution can transform it. How?  Adding prior authorization automation can make your platform “stickier” with your current customers. In addition, it can make you more attractive to prospective customers who are increasingly frustrated by burdensome prior… Read entire article here