In this episode, we are joined by Bevey Minor, EVP of Healthcare IT Strategy & Policy at Consensus Cloud Solutions. She discusses how most payers receive and respond to PA requests today, the main challenge for payers when streamlining authorizations, trends contributing to the healthcare industry's current prior authorization challenges, and much more! This episode is sponsored by Consensus Cloud Solutions.
Summary
Streamlining Prior Authorization: A Discussion with Bevey Minor from Consensus Cloud Solutions
The Current State of Prior Authorization
In this episode, we are joined by Bevey Minor, EVP of Healthcare IT Strategy & Policy at Consensus Cloud Solutions. She discusses how most payers receive and respond to PA requests today, the main challenge for payers when streamlining authorizations, trends contributing to the healthcare industry's current prior authorization challenges, and much more!
Payers are using electronic prior authorization for medications at a rate of over 50%. The main challenge for payers is the manual labor and data entry errors that occur with unstructured documents. There is also physician, patient and health plan dissatisfaction due to delayed treatment. Health plans are attempting to reduce prior authorizations by giving gold stars to physicians who have high approval rates. However, providers struggle to keep up with each health plan's different rules and forms.
The Importance of Prior Authorization
Prior authorizations are important in the referral management process because if an authorization isn't sent from a primary care provider to a specialist, then it can stop the continuity of care. Furthermore, technology like Consensus Cloud Solutions' product Consensus Clarity can help streamline the prior authorization process by using NLP and AI to take an unstructured PDF document and make it more structured, allowing for quicker turn around times and intelligent decision making.
Consensus Clarity: The Solution for Smoother Prior Authorization
Prior authorizations are a process that healthcare providers must go through to get insurance companies to cover certain treatments. In order to make this process smoother, Consensus has developed an NLP AI solution called Clarity. This technology can help speed up referrals and authorizations, leading to better patient outcomes.
About Consensus Cloud Solutions
This episode is sponsored by Consensus Cloud Solutions. Consensus Cloud Solutions is a leading provider of cloud-based healthcare IT solutions that use the power of AI, blockchain, and other emerging technologies to transform the healthcare industry. Consensus Cloud Solutions is committed to helping healthcare organizations improve patient outcomes, reduce costs, and increase efficiencies through innovative technology solutions.
Note: This is an AI generated transcript, not edited by a staff writer and is solely intended for educational purposes. If you have any questions/concerns, reach out to podcasts@beckershealthcare.com
This episode aired on 05/02/2023 and can be listened here.
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