Electronic Prior Authorization

Electronic prior authorization can have a positive impact for both physicians and patients.

According to a news release, an analysis from the America’s Health Insurance Plans (AHIP) found that electronic prior authorization can significantly reduce the time between a request for authorization and a decision and the time to a patient receiving care.

“Prior authorization is an important tool in helping patients receive safe, effective, clinically appropriate care,” Kate Berry, senior vice president of clinical affairs at AHIP, says in the release. “We are always looking for ways to enhance the patient and provider experience, and electronic prior authorization is an example. Today’s analysis provides a blueprint for how to leverage electronic tools to improve prior authorization.”

The study found that 71 percent of experienced providers who use electronic prior authorization reported faster time to patient care, furthermore electronic authorization reduced the time between submitting and receiving a decision from the insurer by 69 percent, according to the release.

Other findings from the study include:

  • More than half of experienced users reported fewer calls and faxes while more than 60 percent reported less time spent of phone calls and faxes.
  • 60 percent of experienced users say that electronic prior authorization made it easier to understand if authorization was required.
  • 57 percent say that electronic prior authorization made it easier to understand the requirements.
  • 54 percent say that electronic prior authorization makes it easier to view the decision.

“The review of over 40,000 transactions showed the impact electronic prior authorization makes in health care,” Denise H. Clayton, PhD, research economist of health economics and evaluation at RTI International, says in the release. “Because clinicians and their staff report more benefits from (electronic prior authorization) when they use it more often, greater provider adoption of (electronic prior authorization) could help further realize its promise.”

For More Information: https://www.medicaleconomics.com/view/electronic-prior-authorizations-help-patient-physicians

3700 Wilshire blvd, suite 979
Los Angeles, California 90010