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Points of Light 2024 Case Study 8
Streamlining Prior Authorization through Comprehensive, Real-Time Data Exchange
Author
Boyd Stewart
Author
Aurene Wilford
The prior authorization process often causes friction between payer and provider organizations due to back-and-forth requests for data. In this case study, enGen worked with the collaborating payer and provider organizations to create a solution for utilization, case, and disease management, thus facilitating better data transparency. Use of this solution led to better turnaround times for prior authorizations and reduced manual tasks.
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Note: This case study was created in conjunction with and presented at the 2024 KLAS K2 Collaborative Summit.
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.