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Case Study

3 steps to prevent prior authorization denials

Prior authorization volumes have surged by 30% in the last five years, placing a burden on providers. Read this case study to get best practices from multiple organizations and learn how one health system achieved an impressive 85% approval rate by deploying specialized prior authorization teams.

Prior authorization (PA) volumes soared by 30% in the last five years. The most laborious task — appealing denials — still predominantly rests with providers. Organizations are tackling this challenge by refining their upstream PA workflows to prevent denials including pinpointing denial causes, creating specialized teams, and automating clinical decision support. Organizations that deploy these solutions see positive results. One organization that deployed specialized prior authorization teams, Valley Key Healthcare (a pseudonym), saw an 85% approval rate within three days.


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AFTER YOU READ THIS
  • You will learn three steps to reduce the prior authorization burden on providers.
  • You will learn how to intervene upstream in the prior authorization process to prevent downstream denials.

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