Prior authorization requires providers to obtain approval from insurance payers for specific services. While it aims to control costs, this process often delays patient care with surveys showing that one in three providers experiences delays. This may lead to postponed appointments and treatments. This inefficiency raises questions about how technology can evolve the authorization system to improve access to care.
Traditionally, prior authorization has been a manual and time-consuming task. Physicians must verify patient information, submit requests, and follow up with insurers, often taking 15-20 minutes per request. If an authorization is denied, the process becomes even more complex, requiring additional documentation and appeals. This manual approach not only consumes valuable time but also imposes a heavy administrative burden, costing up to $11 per authorization.
These delays adversely affect patients, with research indicating that prior authorization can lead to significant treatment postponements, increasing the risk of hospitalization and serious health complications. Despite these risks, many physicians do not appeal denied authorizations due to time constraints, resulting in nearly 70% of patients still relying on outdated methods.
Innovative solutions like Orbit’s AI-powered automation are emerging to streamline this process. Orbit has demonstrated that automation can save providers about 60% of their existing costs, amounting to $449 million in savings across the U.S. healthcare system. Automated systems can complete authorizations in as little as five minutes, drastically reducing the time spent on manual tasks.
In conclusion, the integration of prior authorization process automation represents a transformative opportunity for the healthcare industry. By adopting these technological advancements, healthcare providers can not only reduce administrative burdens but also enhance patient satisfaction and health outcomes. As the demand for timely and efficient healthcare continues to grow, embracing automation will be essential in fostering a more responsive system. Ultimately, improving the prior authorization process is crucial for delivering quality care and ensuring that patients receive timely access to necessary treatments. The future of healthcare lies in leveraging technology to create a more streamlined, efficient, and patient-centered system.
