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Points of Light 2022 Case Study 5
Automation of Prior Authorization Process Reduces Manual Workload for Critical Resources
Author
Boyd Stewart
Author
Lois Krotz
Seeking to reduce the manual effort required to obtain prior authorization, the collaborators in this case study worked together to create a SMART on FHIR link between Conway Medical Center’s EMR and the software used by Palmetto GBA. The link simplifies the process for both the payer and healthcare organizations and frees up resources to work on critical pandemic-related tasks. The stakeholders are now working to expand the automation to additional procedures and healthcare 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's Next?
Writer
Elizabeth Pew
Designer
Madison Moniz
Project Manager
Mary Bentley
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.