How Prior Authorization Software Transforms the Patient Intake Process for You

How Prior Authorization Software Transforms the Patient Intake Process for You

The shift from patients to healthcare consumers has been happening for a while, but it picked up speed after the pandemic. The tide had turned in favor of consumerism by the end of 2021.

According to a report by Press Ganey, a company that analyzes patient experiences, consumer shopping behavior is on the rise and could be important for healthcare providers.

Prior authorization services is one example of a digital solution that can assist establish the correct tone right away. Let’s first examine the reasons for and methods for the alteration in patient expectations.

Healthcare delivery has a higher standard for providers

Organizations that receive high grades often hit three experience parameters when it comes to the most well-liked brands: convenience, affordability, and personalisation.

Consider the ever-popular If there is one reason we have outperformed our counterparts in the internet industry over the last six years, it is because we have concentrated like a laser on the customer experience, according to founder Jeff Bezos.

On the other hand, healthcare practitioners have traditionally prioritized the accuracy of diagnoses and treatments over patient experiences. That’s altering, and not just as a result of consumer healthcare.

Amazon and Walmart, two formidable new competitors who are entering the healthcare market, bring with them sophisticated digital capabilities and customer insights that providers lack. As a result, according to a Deloitte-Scottsdale Institute poll, 92% of providers indicate that raising customer happiness and engagement is the main objective of their digital transformation projects.

Patients prefer simple interactions over obstacles requiring prior authorisation

“Health systems are only belatedly grasping the need to provide exceptional medical treatment and a phenomenal consumer experience—that performing poorly in one function will damage performance in the other,” notes Harvard Business Review.

Positive experiences that boost engagement will be even more crucial as we move towards value-based care. The best care plan in the world won’t be effective if the patient is still disengaged and uninspired as a result of a negative experience.

When you consider that utilization of healthcare provider review sites has increased by 54% since 2019 you can understand how important a great experience is.

  • 45% of Gen Z and Millennials and 57% of Baby Boomers report having reviewed a healthcare provider online.
  • When selecting a provider, 59% of healthcare consumers say they look for at least a four-star average rating.
  • Even if they were receiving a referral from another provider, 84% of people say they would be hesitant to visit a doctor who had less than four stars.

Because the experience component of the equation is so important, healthcare practitioners are turning to technological adoption.

Today, it’s usual to use online portals to make appointments and access medical information. However, patient happiness is a fickle creature, and it suffers when something like prior permission delays the patient trip.

Prior authorization software can streamline patient interactions

What looks like end-to-end prior authorization? Facilitating data transmission between payers’ plans and regulations, providers’ clinical records, and patients’ health and benefit data is the first step.

  • Automated real-time health insurance verification saves staff time from having to call payers or trawl through their websites and clearinghouses. Benefits include time savings and increased staff productivity.
  • Third-party payers that the patient may have overlooked or forgotten are identified via insurance discovery. Benefits: Enhances patient value and increases provider payment rates.
  • The patient’s insurance information, including co-pays and deductibles, are used to determine the patient’s financial responsibilities. Benefits: Transparency in pricing is provided at the point of care, which raises patient satisfaction and boosts provider reimbursement rates.

Healthcare may be behind other sectors in terms of digital transformation, but as patient engagement and satisfaction become major priorities in 2023, providers will be racing to catch up.