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Streamline Prior Authorizations with a Pre-Arrival Workflow Solution

HealthWare Systems Blog

Streamline Prior Authorizations with a Pre-Arrival Workflow Solution

Posted on Monday, July 1, 2019

The results of a recent survey conducted by the American Medical Association illustrate the importance of solutions that can streamline prior authorizations.


The 2018 AMA Prior Authorization Physician Survey found the following:

  1. 91% The percentage of physicians who say the prior authorization process postpones patients’ access to necessary care.

  2. 28% The percentage of physicians who say the prior authorization process has resulted in a serious adverse event for their patients (e.g., “death, hospitalization, disability/permanent bodily damage, or other life-threatening event”).

  3. 86% The percentage of physicians who describe prior authorization burdens as high or extremely high.

  4. Almost 2 Business Days (14.9 hours) The average length of physician/staff time that is devoted to prior authorization requirements per physician per week.

  5. 36% The percentage of physicians who have employees who work solely on prior authorization tasks.

Clearly, health systems face many challenges related to preauthorization.  Patient safety is compromised when care is delayed.  Patient and physician satisfaction are at risk as patients endure frustrating waits for treatment and physicians deal with administrative duties that disengage them from their medical work.

And not only can each prior authorization be costly, but excess costs are also incurred in the forms of extra clerical staff and rework when prior authorizations are denied and must be resubmitted.


According to CAQH CORE, 88 percent of prior authorizations are completed either partially or completely manually; and, the majority of preauthorization issues are related to manual processes.

A pre-arrival workflow solution can automate manual processes and streamline prior authorizations.


With a pre-arrival workflow solution that can streamline prior authorizations, you can address the issues mentioned above:

  1. Faster turnaround times for preauthorization submissions

  2. “Get it right the first time” with data integrity edits and identify issues before the request goes to the insurance company

  3. Prevent errors, technical denials, underpayments, and costly rework

  4. Lower costs per transaction

  5. Improve revenue cycle management

  6. Automate status checks on pending authorizations

  7. Save time for doctors and staff

  8. Reduce or repurpose FTEs

  9. Increase patient and physician satisfaction

A physician works at the computer and the words “Facilitator | Streamline Prior Authorizations” appear.

A pre-arrival workflow solution can streamline prior authorizations and improve staff and physician satisfaction.


Support your physicians by utilizing solutions that make their jobs easier.  Implementing time-savers for physicians can go a long way toward reducing physician burnout, which is often related to stressful and time-consuming administrative workloads.

In addition to increasing physician and employee satisfaction, a pre-arrival workflow solution will improve your revenue cycle and patients’ access to care they need.

Hospitals can no longer afford to delay employing solutions that will streamline prior authorizations and benefit all stakeholders in their organizations.


By Stephanie Salmich

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