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Advancing Gold Carding Through Shared Metrics & Transparency for Outpatient Prior Authorizations
Points of Light 2026 Case Study 23
Author
Mac Boyter
Author
Aurene Wilford
Payer Organization 23 and Healthcare Organization 23 partnered with Rhyme to reduce the administrative burden of outpatient prior authorizations for diagnostic services, which required complex submissions and delegated benefit manager review. Although some services were exempt, limited transparency and transaction issues prevented truly touchless processing. The collaborators integrated a Gold Carding exception program into the healthcare organization’s EHR, enabling automated fast-pass approvals, shared performance dashboards, and automated clinical data extraction for audits. Within six months, touchless authorizations increased from 0% to 14.3%, generating approximately $114,000 in annual labor savings and accelerating patient scheduling.
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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
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. © 2026 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.