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Myndshft Blog

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May 26, 2022

The Great Resignation and Understaffing Are Here. Can Automating Prior Authorization Help You Cope?

by Susan Lawson-Dawson | Healthcare Technology, Prior Authorization, Revenue Cycle Management

The numbers tell the story. Preliminary data from the U.S. Bureau of Labor Statistics saw March job openings outpace new hires by more than 1.3 million. Perhaps even more concerning: 682,000 people left healthcare during the same period. A recent advisory from U.S. Surgeon General Vivek Murthy warns that burnout is a root cause of this ongoing exodus. Acknowledging that the pandemic amplified problems already contributing to burnout, Murthy notes, “… the response to burnout and health worker well-being must be multi-pronged. For example, a health worker may find it difficult to spend sufficient time with patients due to their immediate and overwhelming workload, documentation in electronic health records, or prior authorization paperwork for billing purposes.”

Addressing administrative burdens can help with burnout while addressing an additional issue raised by the great resignation. As Becker’s Hospital Review noted recently, “Hospitals are feeling an enduring consequence of experienced employees’ early retirements and resignations: collective knowledge loss.” These losses are being felt organization wide—in the C-suite, among medical personnel and in administrative offices. Automated prior authorization can help bridge the staffing gap. How? 

Less reliance on tribal knowledge for prior authorizations

Recently, we asked a regional health system VP of Revenue Cycle Management to share his biggest challenge now. His reply? “Human capital. Given what’s going on in the industry, the ability to attract, hire and retain staff is a key concern.” He also noted that most of his peers are experiencing the same problem. “With the great resignation, the great turnover, we all feel as if the jobs have shifted. There’s just not enough people out there to fill our positions.” 

This problem, however, is bigger than filling staff vacancies. From the moment that patient intake begins, staff members who have been around longer have a distinct advantage—experience. Unfortunately, the knowledge they’ve accumulated is locked away in their heads. That means if that person is off sick, on vacation, or pursuing a career change or retirement, less experienced staff no longer have a go-to source for answers. Payer rules and policies change frequently too. When you’re short-staffed, staying on top of changes is even harder, increasing the risk of processing delays or denials. 

Myndshft eliminates the need to rely on the exceptional memory of one person or time-consuming legwork hunting down answers. We combine hands-free automation with Collective Healthcare Intelligence™, a single source of truth for patients’ health and benefits information, providers’ clinical documentation, and payers’ plans and policies. 

This effectively democratizes data, putting it into the hands of all staff instead of the minds of a few. In addition to enabling staff to work more efficiently, it makes on-boarding easier so when you do hire staff, they can get up to speed sooner. 

Tackle prior authorization inefficiencies to fight burnout

The Surgeon General makes it clear that action is needed, and one recommendation in the advisory is to:

“Reduce administrative and other workplace burdens to help health workers make time for what matters. This must include reducing administrative and documentation burdens, as well as the cognitive load on health workers, increasing flexibility in work scheduling, ensuring health information technology that is human-centered, interoperable, and equitable, and aligning payment models to recognize the value of a conversation, not just of a procedure.”

In looking at administrative burdens, the patient intake process is a clear focus point. Benefits verification and eligibility is the most frequently performed transaction, and prior authorization is the most time-consuming due to its complexity. Since they go hand-in-hand, inefficiencies anywhere along this workflow can snowball into treatment delays, preventable denials, costly appeals, and worker burnout. What’s more, AJMC reports that 52% of denials are potentially avoidable and 34% are definitely avoidable. When you’re overburdened and understaffed, reworking denied claims is the last thing you need. 

Streamline your prior authorizations workflow

Automation doesn’t just accelerate the workflow. It reduces error potential from typos or missing information—two common problems when your staff is scrambling to keep up with demand AND is over-reliant on tribal knowledge.  Asked about her own experience with automating processes, Program Manager Jessica D’Ambra said, “The efficiencies gained in using Myndshft are huge for our Insurance Benefits team: Making sure that they’re not in a number of different platforms and websites to gather the information that they need. It’s the one-stop shop. This is a huge improvement over where we were before.”

Because Myndshft delivers automation and Collective Healthcare Intelligence together, productivity and accuracy both get a boost. Myndshft has helped healthcare providers:

  • Improve productivity by >25%
  • Increase staff satisfaction by reallocating them to more rewarding work
  • Eliminate up to 90% of rework through pre-screening that flags errors or info gaps that might trigger a denial

Integrated into your system of record, Myndshft helps you move from patient benefits verification and eligibility, patient financial responsibility and prior authorization in a swift, seamless flow. Data parsing delivers the information needed, without clutter, so your newest hire can work as efficiently as your most tenured staff.

See how automation can ease your staffing burden and health worker burnout.