This case study focuses on the implementation of automation to streamline the prior authorization process for a surgical group. Prior authorization requirements for high-risk procedures and medications have been increasing, leading to manual and time-consuming tasks for medical assistants.
Major Prior Authorization Problem Areas of The Surgical Group:
Manual and time-consuming prior authorization process
Lengthy phone calls with payers for authorization status
Delays in receiving authorizations for high-risk procedures
Administrative burdens and backlog of work for staff
Errors and missed authorizations leading to unexpected bills
Challenges in meeting new clinical guidelines for payment transparency
By leveraging automation technology, the surgical group aims to reduce processing time, improve operational efficiency, minimize errors, and enhance the patient experience.
