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Points of Light 2024 Case Study 18
Automating Prior Authorizations through Networked FHIR Connections
Author
Boyd Stewart
Author
Aurene Wilford
Payer and provider organizations need to be able to effectively and efficiently share data throughout the prior authorization approval process, but the complexities of data sharing often create an administrative burden and high costs for organizations. In this collaboration, Healthcare Organization 18 and Regence partnered with eHealth Exchange to facilitate faster, easier data sharing through FHIR technology. The stakeholders aim to process prior authorizations more quickly via a single data exchange workflow that connects the provider organization with all payer 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.