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Points of Light 2023 Case Study 24 Points of Light 2023 Case Study 24
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Points of Light 2023 Case Study 24
Simplifying the Prior Authorization Process through Automation

author - Boyd Stewart
Author
Boyd Stewart
author - Aurene Wilford
Author
Aurene Wilford
 
April 15, 2023 | Read Time: 1  minute

Manual prior authorization workflows are time consuming and costly for payer and provider organizations and can delay patient access to care. To increase provider visibility into which services require prior authorization and to bring automation to the submission and decision processes, the collaborators in this case study worked together to develop a more automated, self-service solution that allows providers to determine whether a given service requires prior authorization, submit a request, and receive a determination, all within their EMR workflow. The technology has improved efficiency, reduced denials, and increased revenue.

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Key Findings:

  1. Executive Summary
  2. The Collaborators
  3. Points of Friction—Challenges to Be Solved
  4. Action Plan—How the Collaborators Worked Together to Reduce Friction
  5. Points of Light—Outcomes Achieved through Collaboration
  6. Lessons Learned—What Best Practices Can Other Organizations Replicate?
  7. What's Next?—Vision for the Future
author - Elizabeth Pew
Writer
Elizabeth Pew
author - Jess Wallace-Simpson
Designer
Jess Wallace-Simpson
author - Joel Sanchez
Project Manager
Joel Sanchez
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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.