Automated, EHR Integrated, Prior Authorizations at the Point of Care

Real-time prior authorizations deliver improved care, reduce costs and offer provider satisfaction

Now, using cutting-edge technology and years of Clinical Decision Support (CDS) expertise, Stanson Health has automated prior authorizations. The solution can be integrated into your current electronic health record (EHR), offering a payor-agnostic solution that streamlines the process with real-time decisions at the point of care. As your partner, Stanson Health brings more than six years of CDS expertise, serving more than 170,000 providers in over 500 hospitals earning us best in KLAS rankings. Our proven track record makes us the ultimate choice for an automated prior authorization solution. Using natural language processing (NLP) and machine learning (ML), we connect providers and payors with guidelines to instantly determine if an order meets payor requirements for approval based on information gathered from the EHR.

With our prior authorization solution, providers, payors and patients immediately experience the benefit of an automated, real-time prior authorization approval process. Eligibility and clinical necessity are both assessed based on payor guidelines, enabling a real-time decision to be delivered at the point of care. This improves the overall experience for everyone, including the patient, and saves both providers and payors the time and expense spent managing the manual prior authorization process. 

$23 to $31 billion

is spent each year for providers to interact with health insurance plans. 

Real-time Authorizations Using Data in the Chart
  • Eligibility check with payor
  • Medical necessity checking using payor guidelines
  • Furnishing facility selection using payor approved locations
  • Prior authorization submission/automated approval, including providing EHR with payor generated cert ID

Real-Time Authorization Approval

  • Automated prior authorizations integrate into current EHR workflow with payor guidelines to approve authorization requests.
  • Streamlined authorization process results in reduced time delays for both patients and providers.
  • Reduce clinically inappropriate and potentially harmful orders with complete transparency to the payor and health system.
  • Decrease administrative burden for both provider and payor staff allowing them to focus more on patient care.

Contact Stanson Health to learn more about automating your prior authorizations.

Why Automate? The Numbers Tell the Story.

$23 to $31 billion
is spent each year for providers to manually interact with health insurance plans.1

$82,975
is incurred per year in time and labor expenses interacting with multiple insurance plans.2
28%
of physicians reported that the existing prior authorization process led to a serious adverse event.3
26%
of providers reported a wait of at least three business days for a prior authorization decision.
14.9 hours
a week are spent by providers or their staff on administrative duties specific to prior authorization.
91%
of providers reported a negative impact on clinical outcomes due to the current prior authorization process.
75%
of respondents agreed that the hassle associated with the existing prior authorization process can sometimes lead to patients abandoning their treatment.
86% of respondents
agreed that the hassle associated with the existing prior authorization process can sometimes lead to patients abandoning their treatment.4
View Sources Cited

1  Casalino LP, Nicholson S, Gans DN, et al. What does it cost physician practices to interact with health insurance plans? Health Affairs (Millwood). 2009;28(4):w533–43. DOI: 10.1377/hlthaff.28.4.w533.
2  Morra D, Nicholson S, Levinson W, et al. US Physician Practices Versus Canadians: Spending Nearly Four Times As Much Money Interacting With Payers. Health Affairs 2011 30:8, 1443-1450. Available at: https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2010.0893 Accessed May 20, 2019.
3  2018 AMA Prior Authorization Physician Survey. February 2018. American Medical Association, Chicago, IL. Available at: https://www.ama-assn.org/system/files/2019-02/prior-auth-2018.pdf.. Accessed June 3, 2019.
4 https://www.ama-assn.org/practice-management/sustainability/1-4-doctors-say-prior-authorization-has-led-serious-adverse

Resources

Smart, Fast, Efficient:
Introducing Seamless Patient Care

Prior Authorization:
A Better, Faster Way

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1  Casalino LP, Nicholson S, Gans DN, et al. What does it cost physician practices to interact with health insurance plans? Health Affairs (Millwood). 2009;28(4):w533–43. DOI: 10.1377/hlthaff.28.4.w533.
2  Morra D, Nicholson S, Levinson W, et al. US Physician Practices Versus Canadians: Spending Nearly Four Times As Much Money Interacting With Payers. Health Affairs 2011 30:8, 1443-1450. Available at: https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2010.0893 Accessed May 20, 2019.
3  2018 AMA Prior Authorization Physician Survey. February 2018. American Medical Association, Chicago, IL. Available at: https://www.ama-assn.org/system/files/2019-02/prior-auth-2018.pdf.. Accessed June 3, 2019.
4  https://www.ama-assn.org/practice-management/sustainability/1-4-doctors-say-prior-authorization-has-led-serious-adverse