{"id":31641,"date":"2024-11-12T03:00:00","date_gmt":"2024-11-12T03:00:00","guid":{"rendered":"https:\/\/www.syscreations.ca\/blog\/?p=31641"},"modified":"2024-11-12T09:37:34","modified_gmt":"2024-11-12T09:37:34","slug":"electronic-prior-authorization-automation","status":"publish","type":"post","link":"https:\/\/www.syscreations.ca\/blog\/electronic-prior-authorization-automation\/","title":{"rendered":"Electronic Prior Authorization Automation: A Key to Achieving 10X Productivity &#038; Velocity"},"content":{"rendered":"\n<p><span style=\"color:#7b68ee\" class=\"has-inline-color\">Prior authorization is hard to manage, there is no doubt about it.<\/span><\/p>\n\n\n\n<p>Because it is,<\/p>\n\n\n\n<ul><li>Time-consuming for healthcare provider<\/li><\/ul>\n\n\n\n<ul><li>Costlier for healthcare practices<\/li><\/ul>\n\n\n\n<ul><li>Tedious for the payers<\/li><\/ul>\n\n\n\n<p>Almost 94% of physicians in the USA said that <strong><em><span style=\"color:#7b68ee\" class=\"has-inline-color\">prior authorization delays care for 90% of their patients.<\/span><\/em><\/strong><\/p>\n\n\n\n<p>The primary reason behind it is the manual workflows that are surrounded by tedious phone calls.<\/p>\n\n\n\n<p><span style=\"color:#7b68ee\" class=\"has-inline-color\">But you can change that and make this hectic process less frustrating and more productive.<\/span><\/p>\n\n\n\n<p><em>How?<\/em><\/p>\n\n\n\n<p><span style=\"color:#7b68ee\" class=\"has-inline-color\">With electronic prior authorization software!<\/span><\/p>\n\n\n\n<p>It has got potential to bring peace of mind into the lives of providers, payers, and patients.<\/p>\n\n\n\n<p><span style=\"color:#7b68ee\" class=\"has-inline-color\">And you\u2019ll know how in the next 3 minutes!<\/span><\/p>\n\n\n\n<h2><strong>What is Electronic Prior Authorization?<\/strong><\/h2>\n\n\n\n<p>For some medical and prescription care plans, healthcare providers need to take approval from the payers before performing it.<\/p>\n\n\n\n<p>This process is called <strong><span style=\"color:#7b68ee\" class=\"has-inline-color\">prior authorization.<\/span><\/strong><\/p>\n\n\n\n<p>However, this entire process is mostly performed <strong><span style=\"color:#7b68ee\" class=\"has-inline-color\">manually<\/span><\/strong> for treatment and medication plans.<\/p>\n\n\n\n<p>It includes data entry, documentation, phone calls, emails, and fax.<\/p>\n\n\n\n<p><span style=\"color:#7b68ee\" class=\"has-inline-color\">But an electronic prior authorization automation eliminates it easily and securely.<\/span><\/p>\n\n\n\n<p><strong><em>It automates the entire manual process!<\/em><\/strong><\/p>\n\n\n\n<p>From submitting requests to check eligibility and documentation to getting approvals.<\/p>\n\n\n\n<p><span style=\"color:#7b68ee\" class=\"has-inline-color\">Thus, the prior authorization process gets faster for everyone involved in it.<\/span><\/p>\n\n\n\n<h2><strong>Who Can Automate Prior Authorization?<\/strong><\/h2>\n\n\n\n<p>Electronic prior authorization automation is not just limited to providers.<\/p>\n\n\n\n<p><span style=\"color:#7b68ee\" class=\"has-inline-color\">It also assists pharmacy businesses and healthcare payers in streamlining all their workflows associated with it.<\/span><\/p>\n\n\n\n<p>If you are one of them, you can implement automated electronic prior authorization software into your practices.<\/p>\n\n\n\n<h2><strong>How Does Electronic Prior Authorization Software Equipped with RPA Tech Work?<\/strong><\/h2>\n\n\n\n<p>Let\u2019s understand it with a simple example.<\/p>\n\n\n\n<p><span style=\"color:#7b68ee\" class=\"has-inline-color\">We assume that you are a healthcare professional and want to perform a medication-related prior authorization process using the software.<\/span><\/p>\n\n\n\n<p>So in that case, you will have to follow the streamlined workflow mentioned below.<\/p>\n\n\n\n<p><em>(Note: The software is integrated with the EHR.)<\/em><\/p>\n\n\n\n<p><strong><span style=\"color:#7b68ee\" class=\"has-inline-color\">Step 1: Select the medication<\/span><\/strong><\/p>\n\n\n\n<p>As the electronic prior authorization software is already integrated with the EHR, you just need to select the prescription plan for the patient.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" width=\"1366\" height=\"768\" src=\"https:\/\/www.syscreations.ca\/blog\/wp-content\/uploads\/2022\/12\/1-9.png\" alt=\"\" class=\"wp-image-31643\"\/><\/figure>\n\n\n\n<p><strong><span style=\"color:#7b68ee\" class=\"has-inline-color\">Step 2: Check the prior authorization requirement<\/span><\/strong><\/p>\n\n\n\n<p>The software will automatically show you the prior authorization requirements for the selected medication.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" width=\"1366\" height=\"768\" src=\"https:\/\/www.syscreations.ca\/blog\/wp-content\/uploads\/2022\/12\/2-8.png\" alt=\"\" class=\"wp-image-31644\"\/><\/figure>\n\n\n\n<p><strong><span style=\"color:#7b68ee\" class=\"has-inline-color\">Step 3: Submit the electronic prior authorization request<\/span><\/strong><\/p>\n\n\n\n<p>If the medication plan you selected requires prior authorization, you\u2019ll need to perform the entire process before sending the prescription note to the pharmacy store.<\/p>\n\n\n\n<p>And for that, <em>the first step is to submit the request.<\/em><\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" width=\"1366\" height=\"768\" src=\"https:\/\/www.syscreations.ca\/blog\/wp-content\/uploads\/2022\/12\/3-5.png\" alt=\"\" class=\"wp-image-31645\"\/><\/figure>\n\n\n\n<p><strong><span style=\"color:#7b68ee\" class=\"has-inline-color\">Step 4: Answer questions<\/span><\/strong><\/p>\n\n\n\n<p>Once you submit the electronic prior authorization, the software will ask you a few questions.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" width=\"1366\" height=\"768\" src=\"https:\/\/www.syscreations.ca\/blog\/wp-content\/uploads\/2022\/12\/4-4.png\" alt=\"\" class=\"wp-image-31646\"\/><\/figure>\n\n\n\n<p><span style=\"color:#7b68ee\" class=\"has-inline-color\"><em>And these questions directly sync into the EHR.<\/em><\/span><\/p>\n\n\n\n<p>This feature helps the other physicians and staff members to complete the process on your behalf.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" width=\"1366\" height=\"768\" src=\"https:\/\/www.syscreations.ca\/blog\/wp-content\/uploads\/2022\/12\/5-3.png\" alt=\"\" class=\"wp-image-31647\"\/><\/figure>\n\n\n\n<p><span style=\"color:#7b68ee\" class=\"has-inline-color\">These questions may be related to the selected medication plan or pharmacy benefits \u2013 in various forms.<\/span><\/p>\n\n\n\n<p>For example,<\/p>\n\n\n\n<p><strong><span style=\"color:#7b68ee\" class=\"has-inline-color\">1. True False<\/span><\/strong><\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" width=\"1366\" height=\"768\" src=\"https:\/\/www.syscreations.ca\/blog\/wp-content\/uploads\/2022\/12\/6-2.png\" alt=\"\" class=\"wp-image-31648\"\/><\/figure>\n\n\n\n<p><strong><span style=\"color:#7b68ee\" class=\"has-inline-color\">2. Multiple choice<\/span><\/strong><\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" width=\"1366\" height=\"768\" src=\"https:\/\/www.syscreations.ca\/blog\/wp-content\/uploads\/2022\/12\/7.png\" alt=\"\" class=\"wp-image-31649\"\/><\/figure>\n\n\n\n<p><strong><span style=\"color:#7b68ee\" class=\"has-inline-color\">3. Free texts response<\/span><\/strong><\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" width=\"1366\" height=\"768\" src=\"https:\/\/www.syscreations.ca\/blog\/wp-content\/uploads\/2022\/12\/8.png\" alt=\"\" class=\"wp-image-31650\"\/><\/figure>\n\n\n\n<p><strong><span style=\"color:#7b68ee\" class=\"has-inline-color\">Step 5: Answer questions and submit<\/span><\/strong><\/p>\n\n\n\n<p>This is a crucial step as it may create a conflict between you, the pharmacy, and the payers.<\/p>\n\n\n\n<p><span style=\"color:#7b68ee\" class=\"has-inline-color\">Here, you or other staff members need to validate all the answers you have given regarding the medication plan.<\/span><\/p>\n\n\n\n<p>You can explore all answers from a single screen.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" width=\"1366\" height=\"768\" src=\"https:\/\/www.syscreations.ca\/blog\/wp-content\/uploads\/2022\/12\/9.png\" alt=\"\" class=\"wp-image-31651\"\/><\/figure>\n\n\n\n<p><strong><span style=\"color:#7b68ee\" class=\"has-inline-color\">Step 6: Now sit, relax, and wait for the confirmation<\/span><\/strong><\/p>\n\n\n\n<p>Once you submit all the answers, the software will automatically \u2013<\/p>\n\n\n\n<ul><li>Check the eligibility of the medication plan you have chosen<\/li><\/ul>\n\n\n\n<ul><li>Patients\u2019 financial responsibilities<\/li><\/ul>\n\n\n\n<p><span style=\"color:#7b68ee\" class=\"has-inline-color\">It uses AI algorithms and RPA technology to perform these tasks.<\/span><\/p>\n\n\n\n<p>And this process sometimes takes less than 2 minutes.<\/p>\n\n\n\n<p><span style=\"color:#7b68ee\" class=\"has-inline-color\">Once it is done, it will send a real-time notification to you.<\/span><\/p>\n\n\n\n<p>In case a change is needed, it sends an instant notification to you.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" width=\"1366\" height=\"768\" src=\"https:\/\/www.syscreations.ca\/blog\/wp-content\/uploads\/2022\/12\/10.png\" alt=\"\" class=\"wp-image-31652\"\/><\/figure>\n\n\n\n<p><span style=\"color:#7b68ee\" class=\"has-inline-color\">Once a request is approved, you can send an ePrescription note to the pharmacy via SMS and email.<\/span><\/p>\n\n\n\n<p>This entire approach ensures that patients won\u2019t face care delays due to the unmet prior authorization processes.<\/p>\n\n\n\n<h2><strong>Four Crucial Tasks You Can Automate with Prior Authorization Software<\/strong><\/h2>\n\n\n\n<p>The electronic prior authorization system works on RPA technology.<br>It helps you automate almost <strong><span style=\"color:#7b68ee\" class=\"has-inline-color\">80% of your workflows<\/span> <\/strong>including,<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" width=\"1920\" height=\"1080\" src=\"https:\/\/www.syscreations.ca\/blog\/wp-content\/uploads\/2024\/11\/Four-Crucial-Tasks-You-Can-Automate-with-Prior-Authorization-Software.jpg\" alt=\"\" class=\"wp-image-34628\"\/><\/figure>\n\n\n\n<p><strong><span style=\"color:#7b68ee\" class=\"has-inline-color\">1. Demographic audit<\/span><\/strong><\/p>\n\n\n\n<p>It\u2019s important to eliminate the errors in the patient\u2019s demographic data.<\/p>\n\n\n\n<p>Because it may result in<\/p>\n\n\n\n<ul><li>Resubmissions<\/li><li>Denials<\/li><li>Lost revenue<\/li><\/ul>\n\n\n\n<p>By using the software, you can automate this entire process.<\/p>\n\n\n\n<p>For example,<\/p>\n\n\n\n<ul><li>Audit to prevent financial and administrative errors<\/li><li>Real-time alerts when an error occurs<\/li><\/ul>\n\n\n\n<p><strong><span style=\"color:#7b68ee\" class=\"has-inline-color\">2. Verification<\/span><\/strong><\/p>\n\n\n\n<p>You can automate two verifications:<\/p>\n\n\n\n<ul><li>Eligibility<\/li><li>Medical and prescription benefits<\/li><\/ul>\n\n\n\n<p><strong><span style=\"color:#7b68ee\" class=\"has-inline-color\">3. Determination&nbsp;<\/span><\/strong><\/p>\n\n\n\n<p>Undeniably, this is the most time-consuming part of prior authorization.<\/p>\n\n\n\n<p>Because providers need to check everything manually to determine whether the authorization is required or not.<\/p>\n\n\n\n<p>But the software totally eliminates the need to check manually.<\/p>\n\n\n\n<p>With just one click, it lets you determine the prior authorization needed.<\/p>\n\n\n\n<p><strong><span style=\"color:#7b68ee\" class=\"has-inline-color\">4. Submission and retrieval<\/span><\/strong><\/p>\n\n\n\n<p>You can also automate the submission process.<\/p>\n\n\n\n<p>For example,<\/p>\n\n\n\n<ul><li>Automate reminders to payer regarding the submission<\/li><li>Real-time notification in case of the rework<\/li><li>Review authorization status without any need for phone calls<\/li><li>Notification when the prior authorization is confirmed<\/li><\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/www.syscreations.ca\/blog\/rpa-development-with-uipath-cost\/\" target=\"_blank\" rel=\"noopener\"><img loading=\"lazy\" width=\"2000\" height=\"300\" src=\"https:\/\/www.syscreations.ca\/blog\/wp-content\/uploads\/2022\/12\/CTA-blog.jpg\" alt=\"CTA blog\" class=\"wp-image-31658\"\/><\/a><\/figure>\n\n\n\n<h2><strong>What is the Importance of Having Automated Electronic Prior Authorization?<\/strong><\/h2>\n\n\n\n<p>Let&#8217;s understand with the simple difference between manual and automated prior authorization approaches.<\/p>\n\n\n\n<p><strong><span style=\"text-decoration: underline;\">1. Manual process: You&#8217;ll get clear approval in 1 to 10 days<\/span><\/strong><\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" width=\"1920\" height=\"1080\" src=\"https:\/\/www.syscreations.ca\/blog\/wp-content\/uploads\/2022\/12\/Manual-approach.jpg\" alt=\"Manual prior authorization\" class=\"wp-image-31653\"\/><\/figure>\n\n\n\n<p><strong><span style=\"text-decoration: underline;\">2. Automated process: You&#8217;ll get clear approval in less than 5 minutes<\/span><\/strong><\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" width=\"1920\" height=\"1080\" src=\"https:\/\/www.syscreations.ca\/blog\/wp-content\/uploads\/2022\/12\/Automated-approach.jpg\" alt=\"Electronic prior authorization automation\" class=\"wp-image-31655\"\/><\/figure>\n\n\n\n<h2><strong>What are the Benefits of an Automated Prior Authorization System?<\/strong><\/h2>\n\n\n\n<p><span style=\"color:#7b68ee\" class=\"has-inline-color\">The electronic prior authorization software brings the patients, providers, and payers under the same roof.<\/span><\/p>\n\n\n\n<p>And the following are the top benefits of it.<\/p>\n\n\n\n<ul><li>No need to fill out the prior authorization form<\/li><\/ul>\n\n\n\n<ul><li>No need for Fax and phone calls<\/li><\/ul>\n\n\n\n<ul><li>Eliminates the data entry process<\/li><\/ul>\n\n\n\n<ul><li>Can avoid performing multiple tasks at the same time<\/li><\/ul>\n\n\n\n<ul><li>Completely match your ePrescribing workflows<\/li><\/ul>\n\n\n\n<ul><li>Reduces the processing time<\/li><\/ul>\n\n\n\n<ul><li>Accelerate patient time to treatment<\/li><\/ul>\n\n\n\n<ul><li>Lowers the chances of claim rejection at drug pharmacy<\/li><\/ul>\n\n\n\n<ul><li>Reduces administrative burden<\/li><\/ul>\n\n\n\n<ul><li>Boost patient satisfaction<\/li><\/ul>\n\n\n\n<h2><strong>Want to Automate your Prior Authorization with Software? We Can Help You with Our 3Es<\/strong><\/h2>\n\n\n\n<p>We are an Ontario-based healthcare IT company.<\/p>\n\n\n\n<p>And we are well-known in the North American health tech market because of our 3Es.<\/p>\n\n\n\n<p><strong><span style=\"color:#7b68ee\" class=\"has-inline-color\">Expertise:<\/span><\/strong><\/p>\n\n\n\n<p>We entertain only healthcare IT projects for \u2013 startups, enterprises, organizations, and individuals.<\/p>\n\n\n\n<p>And we are not just limited to the app and software development.<\/p>\n\n\n\n<p>We also have ultimate expertise in \u2013 AI, ML, health tech integration, IoT or wearable device integration, VoIP, and automation.<\/p>\n\n\n\n<p><strong><span style=\"color:#7b68ee\" class=\"has-inline-color\">Experience:<\/span><\/strong><\/p>\n\n\n\n<p>We have extensive experience in breaking business, technical and compliance roadblocks.<\/p>\n\n\n\n<p>And we have been doing it for 8+ years!<\/p>\n\n\n\n<p><strong><span style=\"color:#7b68ee\" class=\"has-inline-color\">Experts:<\/span><\/strong><\/p>\n\n\n\n<p>This is something that sets us apart from the rest of the IT companies.<\/p>\n\n\n\n<p>Every team member on our 50+ IT teams is healthcare-specific!<\/p>\n\n\n\n<p>In other words, they have been performing health tech projects since the first day of their professional careers.<\/p>\n\n\n\n<p>It includes \u2013 web and app developers, UI\/UX designers, business analysts, compliance specialists, AI and ML experts, RPA engineers, and integration experts.<\/p>\n\n\n\n<p><span style=\"color:#7b68ee\" class=\"has-inline-color\">So, if you want to perform prior authorization with less frustration and more productivity, let\u2019s conduct a call and talk about your ultimate goals!<\/span><\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/www.syscreations.ca\/contact\/\" target=\"_blank\" rel=\"noopener\"><img loading=\"lazy\" width=\"2000\" height=\"300\" src=\"https:\/\/www.syscreations.ca\/blog\/wp-content\/uploads\/2022\/12\/CTA.jpg\" alt=\"CTA pricing\" class=\"wp-image-31657\"\/><\/a><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>Prior authorization is hard to manage, there is no doubt about it. Because it is, Time-consuming for healthcare provider Costlier for healthcare practices Tedious for the payers Almost 94% of physicians in the USA said that prior authorization delays care for 90% of their patients. The primary reason behind it is the manual workflows that [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":31642,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[10],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v16.1.1 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>RPA-based Solutions to Automate Electronic Prior Authorization<\/title>\n<meta name=\"description\" content=\"Know how automated electronic prior authorization software can help you save 80% of time, resources &amp; costs on prior authorization.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.syscreations.ca\/blog\/electronic-prior-authorization-automation\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Electronic Prior Authorization Automation\" \/>\n<meta property=\"og:description\" content=\"Built with AI &amp; 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