A Technology-Driven Approach to Prior Authorization Transformation: How Payers & Providers Can Innovate Together

Prior authorization is often an inefficient slog — but does it need to be? Emerging technology provides a means for healthcare organizations to jettison antiquated, burdensome authorization tasks that drive up costs and lessen patients’ ability to access appropriate care in a timely manner.

If stakeholders adopt digital approaches that automate time-consuming manual processes and streamline authorization requests, they can vastly reduce the time and resources they need to spend on administrative tasks, thereby increasing efficiency, expanding capacity, and reaping substantial cost savings. This article will further consider:

• The financial and operational argument for adopting automated utilization management to digitize prior authorization processes
• How CareIQ, an innovative tool built atop Salesforce® Health Cloud, can facilitate more accurate authorization decision-making, improve authorization turnaround, maximize cost savings, and contribute to enhanced experiences for payers and their provider networks
• How a large global health services company leveraged a technology-driven approach to streamline and standardize 100% of its prior authorizations, even for complex cases involving chronic care and behavioral health
• Why payers and providers alike should collaborate with an implementation partner when undergoing a digital transformation