In testimony to Congress several years ago, Harvard Applied Economics professor David M. Cutler, PhD likened administrative costs to an “economic arms race.” He explained that pressure to reduce spending frequently takes the form of payers setting additional administrative requirements like prior authorization to rein in costs. This tactic, however, increases the administrative burden for payers and providers. Ultimately, Cutler suggests, “The net effect is a spiral of cascading administrative costs on both sides of the market, with no benefit to patients and no net benefit to insurers or providers.” And patients are caught in the middle. Enter prior authorization… Read entire article here
Prior authorizations play a crucial role in the revenue cycle. The process greatly impacts reimbursement and patient access to care, and consequently, the financial performance of healthcare organizations. To simplify the process and reduce denials, a growing number of healthcare providers have pinned their hopes on prior authorization automation. The benefits of adopting prior authorization automation Prior authorization automation shows promising results across the healthcare industry. Reporting on a recent survey, HealthLeaders notes that 78% of respondents saw improved financial performance following implementation of automated prior authorization. What contributes to better bottom lines? Automation eliminates repetitive data entry, improving staff… Read entire article here
Our healthcare landscape is riddled with challenges. Recently, research has called attention to a growing problem: patient discharge delays. An increase in the length of patient stays in hospitals creates capacity issues and delays in new patient admissions. This scenario not only strains hospital resources, but it also has adverse effects on patient health. The culprit? A range of factors contribute—from prior authorization delays and denials to staffing shortages. Prior authorization software can help turn the tide. Before we dive into how, let’s look at the challenges at hand. Patients stays on the rise, according to AHA report A December… Read entire article here
Is your prior authorization process due for an upgrade? Time and again, we’ve seen surveys and analyses that highlight rampant inefficiencies in today’s primarily manual process. The lack of interoperability contributes. So do inconsistent standards for prior authorization across payers. As a result, providers—and the patients they serve—get bogged down in administrative paperwork that contributes to treatment delays or worse. In fact, reports Fierce Healthcare, 91% of physicians say that prior authorizations have a negative impact on patient clinical outcomes. Legislation and regulations to address prior authorization are on the horizon, but let’s face it—enacting and enforcing those rules will… Read entire article here
