Posted by Janna Vienca Cañezal
Prior authorization can be cumbersome and cost your clinic. It may be beneficial to patients and insurance company financials, but we can’t deny that PA is a dreaded, additional step that healthcare providers have to go through. Thanks to electronic prior authorizations, or ePA, however, it doesn’t have to be.
Over the years, there have been technological developments to make the prior authorization process more efficient. In 2011, AMA published a white paper recommending an electronic standard transaction for prior authorizations to streamline the process and reduce the burden it brings to physicians. Many companies developed their software and portals to accommodate the change, and they quickly saw that the process could be even more efficient with the integration of an EHR. As an integral part of any modern practice, the pair just made sense, and modern electronic prior authorization was born.
Benefits of ePA Integrated Solutions in an EHR
Traditionally, patients would go to their pharmacy, the pharmacist launching into a series of lengthy calls to see if a prior authorization is required and to get approval if necessary. All that happened while the patient was just waiting.
According to CoverMyMeds, an ePA solutions provider with a network of over 60,000 pharmacies, 37% of PA-related claim rejections are abandoned by patients at the pharmacy. That leads to patients leaving their recommended course of treatment, worsening their condition, and creating more unnecessary work for providers. It poses an even bigger problem for patients suffering from chronic pain and other conditions that require consistent medications. Thankfully, ePA offers an easier solution, benefiting practices and patients alike.
Real-time Results
Patients suffering from chronic pain need immediate solutions. An electronic Prior Authorization system allows providers to get PA results in real-time. If it’s integrated with an EHR, providers can start the PA process at the point of prescription because it is integrated right into their EHR’s prescription workflow. You may even have the results back before the patient has left the clinic.
Automated Process
PA requests done in EHRs are automatically populated with the patient’s information and medication data. It saves your staff valuable time in filling out all the necessary fields in the PA form.
Less Turnaround Time
In an ePA process, requests are sent and received electronically, eliminating numerous phone calls and faxes. Staff can spend less time doing prior authorization work and more on patient care. That rings especially true for pain management clinics where patients suffering from chronic pain need immediate attention and ongoing access to care.
Happier Patients with Electronic Prior Authorization
Prior authorizations can only be checked at the pharmacy most of the time. Patients are surprised that the pharmacist needs to go through several phone calls before providing the medication. Patient wait times can virtually disappear with a streamlined ePA process right from an EHR. Providers can check right away if prior authorization is required, without waiting for the pharmacy to inform them, and patients can get their medications faster, increasing their adherence to the prescription. Creating efficient electronic prior authorizations helps to improve the overall satisfaction of patients.
33% of Americans have chronic pain and will likely use medication to manage it. With that in mind, pain management providers in particular benefit from an integrated ePA right from their EHR. This already complex process shouldn’t be a burden, and it doesn’t have to be if you use the right tools.
IMS has partnered with CoverMyMeds to streamline an efficient electronic prior authorization process. The ePA system is built right into your IMS prescription platform, so you don’t have to worry about creating additional steps in an already established clinical workflow. Automating your ePA process with IMS and CoverMyMeds is a win-win situation for all those involved. Ensure that your patients get the medicine they need to live a pain-free, stress-free life.
