Case Study

Automating Prior Authorization for a Surgical Group

Healthcare Robotic Process Automation Usage, Success and Implementation


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.

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