Epic Prior Authorization Boosts Efficiency in Healthcare

Epic prior authorization is a game-changer for healthcare efficiency. It streamlines the process of obtaining prior authorization, reducing administrative burdens and freeing up staff to focus on patient care.

Epic's prior authorization solution automates the workflow, allowing providers to submit requests electronically and track their status in real-time. This eliminates the need for manual phone calls and faxes, significantly reducing the time spent on prior authorizations.

Studies have shown that Epic's prior authorization solution can reduce the time spent on prior authorizations by up to 80%. This means more time for patients and less time spent on paperwork.

By automating the prior authorization process, Epic's solution also reduces errors and denials, ensuring that patients receive the care they need in a timely manner.

For another approach, see: Prior Authorization Process Flow Chart

Our solution is integrated with the EPIC patient database, streamlining the prior authorization process for healthcare providers. This integration enables seamless access to patient information, reducing manual entry and increasing efficiency.

By partnering with Surescripts, you get connected to a whole network of providers, pharmacies, and payers involved in medication prior authorizations. This connection is crucial for a smooth prior authorization process.

Here are some key benefits of our EPIC integration:

By leveraging our EPIC integration, healthcare providers can reduce manual reviews, improve operational efficiency, and increase productivity. This leads to better clinical outcomes, expedited treatment, and happier patients.

The authorization process is a crucial step in ensuring patients receive the medications they need. Electronic Prior Authorization (e-PA) is a game-changer in this regard, allowing medication prior authorization requests to be processed and managed electronically from within Epic.

There are two types of Medication Prior Authorizations: Prospective PA, initiated at the point of prescribing, and Retrospective PA, initiated by pharmacy where script is to be filled.

The e-PA process can be streamlined for various organizations, including EHR vendors, Health plans, Health systems, Patient access vendors, and PBMs. This can help them improve medication-related decision-making and reduce delays.

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Fast-tracking prior authorizations at the point of care can alleviate delays and frustration. A fully integrated solution can let users proactively initiate requests and receive quick responses.

Here's a breakdown of the benefits of e-PA for different types of organizations:

By automating the prior authorization process, organizations can reduce administrative burden and improve patient outcomes. Electronic Prior Authorization can help determine whether a prescription is covered sooner, with one health system seeing a 69% decrease in median time to a decision compared to manual prior authorization.

Electronic authorization is a game-changer for healthcare teams. It allows Medication Prior Authorization requests to be processed and managed electronically from within Epic. There are two types of Medication Prior Authorizations: Prospective PA, which is initiated at the point of prescribing, and Retrospective PA, which is initiated by pharmacy where script is to be filled.

Electronic authorization can help streamline your team's processes and improve medication-related decision-making. It can benefit EHR vendors, health plans, health systems, patient access vendors, and PBMs.

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Prior authorization workflows can be made more efficient with electronic authorization. It alleviates delays and frustration by letting users proactively initiate requests and receive quick responses. This can be especially helpful when dealing with specialty medications, which often require prior authorization.

Electronic authorization can automatically send questions, receive answers and attachments, send responses, and initiate renewals. This eliminates the inefficiencies and administrative burden of manual processes.

With electronic authorization, prescriptions can be processed sooner, and patients can get the medication they need faster. In fact, one health system improved its pickup rate by six percentage points using Surescripts.

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Using Electronic Prior Authorization (EPA) can significantly reduce the time it takes to get a decision on a prescription. In an AHIP study, the median time to a decision decreased by 69% compared with manual prior authorization.

This means that patients can get the medication they need faster, which is especially important for those with chronic conditions. Electronic Prior Authorization can also reduce the administrative burden on healthcare providers, allowing them to focus on patient care.

One health system using Electronic Prior Authorization saw its average wait time drop by more than two days. This is a significant improvement that can make a big difference in patient outcomes.

Here are some key benefits of Electronic Prior Authorization:

By streamlining the prior authorization process, Electronic Prior Authorization can help healthcare providers and payers work more efficiently together. This can lead to better patient care and improved health outcomes.

We're seeing significant time savings with electronic prior authorizations, with some cases reducing the time from 45 minutes to just a few minutes.

By automating the process, healthcare providers can finish 10 electronic prior authorizations in the time it takes to finish one or two manually during a day.

This is a game-changer for busy healthcare professionals who need to focus on patient care, not administrative tasks.

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Cohere Health Solutions is a game-changer for healthcare providers and patients alike. By leveraging AI-driven prior authorization solutions, Cohere Health simplifies and expedites prior authorization requests, reducing the administrative burden on providers.

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This integration with Epic's Payer Platform enables providers to submit authorization requests directly in their EHR workflow, greatly reducing staff time spent on authorizations. The capability will be available with Epic EHR instances nationwide.

Cohere Health's AI-driven solutions accelerate care approval for providers and patients, reducing associated administrative expenses. By leveraging the prior authorization process, Cohere uniquely improves the entire patient care episode or journey.

Currently, Cohere is processing 5.5 million prior authorization requests annually, positively impacting more than 15 million health plan members and 420,000 healthcare providers nationwide. This partnership with health plans emphasizes a shared dedication to optimizing care access and delivery.

Here are some key benefits of Cohere Health Solutions:

Epic prior authorization makes it easy to get the right treatment for your patients. Eligibility and formulary data is provided in the E-Prescribing workflow, including prior authorization requirements.

This means that you can quickly see if a patient is eligible for a medication and if it's covered by their insurance plan. The request triggers the benefit plan to send the appropriate question set to your electronic health record (EHR).

Users can complete only the required information without leaving their EHR, making the process much faster and more efficient. Benefit plans respond within the same workflow, so you can get the information you need quickly.

Fast approval increases speed to therapy, which is essential for supporting patient adherence and improving health outcomes.

Fast-track authorizations can make a huge difference in patient care and satisfaction. This is especially true for specialty medications, where prior authorization can often be a barrier to timely treatment.

One health system improved its pickup rate by six percentage points by using Electronic Prior Authorization. This is a significant improvement that can make a big difference in patient care.

To fast-track authorizations, you can use Electronic Prior Authorization to securely deliver plan-specific question sets, decisions, and responses to provider workflows. This eliminates the inefficiencies and administrative burden of manual processes.

Automating the prior authorization process can also help reduce wait times. In fact, the median time to a decision decreased by 69% compared with manual prior authorization in an AHIP study.

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Here are some benefits of fast-tracking authorizations:

By fast-tracking authorizations, you can improve time to therapy and get better, faster information from prescribers. In one case, the average wait time dropped by more than two days for a health system using Electronic Prior Authorization.

Electronic member data management is a crucial part of the prior authorization process. This involves collecting and updating member information, such as demographics, medical history, and insurance details, in a centralized database.

The goal is to ensure that this data is accurate and up-to-date, which can be challenging due to the complexity of health plans and the frequency of member changes. Electronic data management can help streamline this process.

According to the article, a well-designed electronic data management system can reduce administrative burdens and improve the overall patient experience. This is achieved by automating tasks, such as data entry and verification, and providing real-time access to member information.

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Member data is typically collected from various sources, including member applications, claims submissions, and provider communications. This data is then integrated into the electronic data management system for analysis and decision-making.

By leveraging electronic data management, healthcare organizations can improve operational efficiency, reduce errors, and enhance the overall quality of care.