How will you solve your prior authorization problem?

Today, like no other time in the past, hospitals and providers are under tremendous pressure to reduce costs and maintain margins in a rapidly shifting landscape. Health care executives are looking for ways to improve care while both managing their bottom line and overcoming the friction between their patients and cost-conscious insurance companies.

Among the most burdensome and costly administrative challenges is prior authorization. With prior authorizations volumes increasing 14% each year, it is becoming one of the biggest obstacles in providing timely care for patients and the primary driver of preventable write-offs for hospitals and providers today.

91% of physicians report care delays due to prior authorization78% of physicians report prior authorizations lead to abandoned tests and procedures

In this paper, we cover the financial impact prior authorization has on organizations and solutions that executives can leverage to help ease the strain including centralized workflows, robotic processing automation (RPA), and artificial intelligence (AI).

Artificial intelligence is making leaps and bounds across industries and is the most exciting solution available to solve the prior authorization challenge today.

Every healthcare executive looking to reduce costs, streamline processes, and, improve patient care should consider implementing this technology. In time, experts predict that organizations that leverage artificial intelligence and future-proof their business will dramatically overtake those that don’t, as competition increases, margins thin, and complexity accelerates.

Read why artificial intelligence is the key for healthcare executives looking to solve prior authorization and improve both the financial and operational health of their organization.

Download CXO Paper

NOTES:

  • 2019 CAQH Index. “Prior Authorization Getting Much Needed Attention.” Catalyst Newsletter. Available from https://bit.ly/3gxFliC
  • 2020 AMA. Prior Authorization Physician Survey 2019. American Medical Association. Available from https://bit.ly/2O2jBiE
  • 2016 S. Terra. “Avoidable Technical and Clinical Denial Write-Off Management in Hospitals, Physician Offices, and Clinics.” Professional Case Management. Available from https://bit.ly/31Q56qg
  • 2016 K. Lachney. “Medical Billing Denials Are Avoidable: How to Help Prevent the Top 5.” Change Healthcare. Available from https://bit.ly/2ZHM2HZ
  • 2016 J. McCormick. “Predictions 2017: Artificial Intelligence Will Drive The Insights Revolution.” Forrester. Available from https://bit.ly/2Z2bKaY

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