Enhancing Prior Authorization With Technology Innovation

Prior authorization process automation in healthcare requires providers to obtain insurance approval for specific services. While intended to manage costs and ensure appropriate care, this system often results in significant delays with one in three providers reporting that such delays impede timely patient access.

The traditional manual process is labor-intensive, requiring providers to verify insurance details, submit requests, and follow up, often resulting in 15-20 minute wait times. If denied, additional documentation or appeals complicate matters further. This complexity contributes to rising costs, with providers spending approximately $11 per manual authorization and 20 minutes on each task.

In contrast, automated prior authorization systems streamline the process by swiftly retrieving necessary patient data, validating information, and preparing requests. Orbit’s AI-powered solution has demonstrated substantial benefits, saving providers about 60% in costs and generating $449 million in savings for the U.S. healthcare industry.

By reducing processing time to just five minutes and freeing up nearly 12 hours of labor weekly per staff member, Orbit enhances patient experiences and increases accuracy. This innovative approach addresses the pressing challenges of prior authorization, ensuring patients receive timely care without unnecessary delays.

 

Source: Orbit Healthcare