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Points of Light 2024 Case Study 15
Reducing Administrative Burden & Time to Care by Automating Prior Authorization for Inpatient Stays
Author
Boyd Stewart
Author
Aurene Wilford
For the provider organization in this collaboration, the process of gaining prior authorization for inpatient stays was labor and time intensive. Additionally, the payer organization often had to deal with incomplete submissions. To address these challenges, the stakeholders worked with Rhyme to streamline the prior authorization process through automatic data sharing. Targeted outcomes include faster decision rates and turnaround times for prior authorizations and a reduced administrative burden for the payer and provider organizations.
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Key Findings:
- Executive Summary
- The Collaborators
- Points of Friction—Challenges to Be Solved
- Action Plan—How the Collaborators Worked Together to Reduce Friction
- Points of Light—Outcomes Achieved through Collaboration
- Lessons Learned—What Best Practices Can Other Organizations Replicate?
- What's Next?—Vision for the Future
Writer
Natalie Hopkins
Designer
Jess Wallace-Simpson
Project Manager
Joel Sanchez
This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2024 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.