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Electronic prior authorizations reduce burden, time spent, finds AHIP and RTI


(Dense Clayton of RTI International discusses prior authorizations during a Zoom call Wednesday.) Handling prior authorization requests electronically as opposed to manually can reduce the median time between submitting a PA request and receiving a decision — clocking in at around three times faster for a time reduction of about 69%, according to findings presented in a Zoom call today by America’s Health Insurance Plans.

The analysis, handled in conjunction with independent nonprofit analytics firm RTI International, also found that faster time to patient care, lower provider burden and improved information for providers are among the benefits of electronic prior authorization capabilities.

Denise Clayton, who leads health economics and evaluations work at RTI, said the analysis was meant to build on a 2018 consensus statement that contained broad support for PA as an opportunity to improve administrative processes. The work examined 40,000 manual and electronic PA requests from health plans, finding that the COVID-19 pandemic has little statistical impact on the findings.


In addition to faster time to decision, electronic PA processes also result in faster time to patient care, the findings showed. Providers reported that patients received care faster after the former implemented electronic processes; among those […]

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