Prior authorization in healthcare is a process requiring providers to obtain insurance approval before delivering specific services. While designed to manage costs and ensure appropriate care, this system often leads to significant delays in patient treatment. One in three providers reports that these delays hinder timely access to care, highlighting the need for improvements in the authorization process.
The traditional manual approach to prior authorization is time-consuming with providers having to verify patient insurance details, review medical records, submit authorization requests, and follow up with insurance companies. This often results in lengthy phone calls, navigating complex online systems, and wait times of 15-20 minutes per request. If authorization is denied, providers must gather additional documentation or appeal the decision, complicating the process further and prolonging wait times for patients.
The manual system imposes high costs on healthcare providers, with expenses reaching approximately $11 per authorization and many providers hiring additional staff solely to manage these requests. Moreover, 93% of physicians report feeling significant administrative burdens due to prior authorization tasks.
In this challenging landscape, prior authorization automation systems offer a more efficient solution. Orbit’s AI-powered technology streamlines workflows by swiftly retrieving necessary patient data, validating information, and preparing authorization requests in as little as five minutes. This system has saved providers around 60% in costs and generated approximately $449 million in savings across the U.S. healthcare industry.By reducing turnaround times and freeing up nearly 12 hours of labor per week for each staff member, Orbit enhances patient experiences and improves accuracy. This innovative approach effectively addresses the inefficiencies of prior authorization, ensuring that patients receive timely care without unnecessary delays.
Source: Orbit Healthcare
