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Points of Light 2022 Case Study 12
ePA and RTPB Technology Used to Reduce Unnecessary Prior Authorizations, Increase Price Transparency
Author
Boyd Stewart
Author
Lois Krotz
Lack of patient-level insurance coverage data at the point of care can add to the administrative burden for provider organizations, pharmacy benefit managers, and payers and lead to high prescription costs for patients. The technology in this case study helps reduce these issues by confirming whether prior authorization is needed and embedding patient-specific formulary information into the prescriber’s workflow. The results have been a win for all stakeholders involved.
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's Next?
Writer
Elizabeth Pew
Designer
Madison Moniz
Project Manager
Robert Ellis
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.