Fixing Inefficient and Costly Prior Authorization: A Path to Modernization

Prior Authorization: A critical barrier to revenue cycle management

As the year 2024 unfolds, the urgency of addressing the inefficient and costly authorization process for healthcare financial leaders persists. With its intricate web of time and resource consumption, this process is a pressing issue, from securing preauthorizations for treatments to managing ongoing authorizations for continuous care. The delays in obtaining authorizations not only impact revenue and cash flow but also impose a significant financial burden on healthcare providers, disrupting patient care and satisfaction.

Recent market insights shed light on the severity of the problem. Manual authorization procedures are time-consuming and expensive. According to CAQH Index research, they take up to 45 minutes per procedure and cost an average of $13. When multiplied by the number of procedures conducted daily, these figures highlight the significant financial and time burden they impose. The study also found that 62% of healthcare providers actively seek technological advancements to streamline their authorization processes, showing a pressing need for change in the industry.

Chief Financial Officers (CFOs) grapple with revenue optimization due to underpayments and denials during the preauthorization process. Lack of visibility into the prior authorization approval timeline hampers the ability to forecast revenue. VPs of Revenue Cycle are dealing with outdated and inefficient prior authorization systems, leading to complex, manual and labor-intensive processes. Directors of Patient Access are facing the consequences of delayed preauthorizations, which can potentially harm patient care and satisfaction.

Bottom-line: the current authorization process is broken. An innovative solution is needed to empower healthcare financial leaders to modernize.

Revolutionizing prior authorization through technology

Forward-looking healthcare financial leaders have alerted FinThrive to the importance of optimizing the authorization process for revenue management — and we've listened.

FinThrive has launched Authorization Manager, a new module in our existing patient access suite of solutions, Access Coordinator (which streamlines pre-service and intake such as scheduling, check-in, payments, insurance verification and more).

Authorization Manager brings predictive analytics and automation to front office teams, helping to streamline each stage of the authorization process, from determination to submission to status monitoring and successful approval — driving significant time savings. We’re dedicated to liberating our customers from an inefficient and costly authorization process.

Checklist for solving prior authorization 

	Automated Authorization Requests Eliminate tedious paperwork and endless phone calls. Automate your request process, sending requests directly to payers and providing real-time status updates.
	Customizable Workflows Tailor the authorization process to fit your organization. With customizable workflows, you can define rules, triggers and notifications to streamline approvals and ensure compliance.
	Seamless EHR Integration Seamlessly integrate with leading electronic health record (EHR) systems, enabling smooth data exchange and eliminating duplicate data entry.
	Analytics and Reporting Uncover valuable insights into authorization trends, denials and approval rates with analytics and reporting. Identify bottlenecks, track performance metrics and optimize your revenue management strategies.
	Real-Time Patient Identification Verify your patients’ identities instantly to further accelerate authorizations. (“Real-Time ID” coming soon in Authorization Manager.)

The benefits of solving prior authorization

1. Prevention of Denials
Providers like you can prevent payer denials by streamlining their prior authorization processes. Prompt and accurate authorization acquisition reduces the risk of claims denial, protecting revenue and enhancing financial health.

2. Patient Satisfaction
By minimizing delays in the authorization process, you can significantly enhance patient satisfaction and confidence in the care they receive. A positive patient perception is a key driver of organizational success, and a streamlined authorization process is a vital part of the patient experience.

3. Improved Revenue Management
You can optimize operational efficiency and minimize costs by reducing the time and resources spent on manual authorization tasks. Additionally, you can maximize revenue capture and maintain a healthy financial bottom line by preventing denials and ensuring timely reimbursement for authorized services.

Learn more about all the ways FinThrive can help you submit clean claims and prevent denials. Fill out this form to request someone contact you.