case study with michigan health system

Case Study

850-Bed Tertiary Care Health System in Michigan uses PriorAuthNow to Increase Staff Productivity Over 200%

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The Challenge

The manual prior authorization process created significant negative impacts for a centralized authorization department at a health system in Michigan.

The Outcome

Achieved over 200% improvement in staff productivity

Saved 55% on prior auth processing staffing costs

Achieved a 40% increase in prior auth determinations every month

Manual Prior Authorizations Create Significant Negative Impacts for Health Systems

The burden of a manual medical prior authorization process was significantly impacting 120 authorization specialists in the centralized authorization department at a 850-bed tertiary care health system in Michigan. Processing 13,000 auths per month manually was creating high turnover for the team and affecting patient care. They needed an automated prior authorization process to ultimately help their authorization specialists become more efficient and provide timely care to patients. 

Seeking a Solution

The health system sent out a Request for Proposal asking potential vendors to implement a real-time automation (RTA) solution. The RTA solution needed to allow the authorization team to: 

Complete all prior authorization in Epic work queue

The central authorization team needed efficiency built in instead of sending emails, calling payers or logging into multiple payers.

Automatically update statuses of authorization requests

Provide central authorization team with automatic status updates until a final determination is rendered.

Automatically route authorizations to payers

The central authorization team wanted a solution that would auto-route all authorizations to all payers.

Three Key Differentiators Set PriorAuthNow Apart from Other Solutions on the Market

The only solution with direct connectivity to the largest and fastest growing network of integrated payers.

Ability to support multiple modalities and clinical expansion for all prior authorizations.

A single entry point for sending and receiving prior authorization data within Epic EHR.

Dramatic Results with PriorAuthNow

The health system was able to see positive impact soon after go-live with PriorAuthNow.

200+%

Improvement in staff productivity

55%

Savings on prior auth processing staffing costs

40%

Increase in prior auth determinations every month

Ready to automate your prior authorizations?

Schedule a free demo to see how we can help your central authorization team become more efficient.