Anyone who has worked in a healthcare provider’s office is more than likely all too familiar with prior authorizations. Prior authorizations involve the process of obtaining consent from a health insurance payer to ensure that healthcare providers can bill the insurance directly. Unfortunately, these requests are not always approved.
Around 1 in every 5 physicians always have to appeal negative prior authorization decisions, but almost half of healthcare provider offices don’t have the time, staff, or resources to properly pursue them for beneficial patient outcomes. While waiting for a positive outcome to the prior authorization, 25% of patients are hospitalized, 19% suffer life-threatening events, and 9% experience disability or permanent bodily damage.
Fortunately, AI has revolutionized the way that prior authorizations happen. Rather than manually compiling records, submitting documents, and filling out appeals, AI uses prior authorization process automation of the whole process. From collecting the documents to submitting it through the portal, it does it all including checking the status of prior authorization requests and updating the record if it gets approved. This AI saves time, money, and especially effort, for just about anyone who is able to take advantage of it. Regardless of how you serve your patients, prior authorization AI is the right tool for your business.
Source: Orbit Healthcare
