Prior authorization is essential in healthcare, enabling providers to seek insurance approval for specific services. However, it often creates significant delays in patient care. Surveys show that one in three providers experiences delays, leading to postponed appointments and treatments. The traditional manual process is time-consuming, requiring staff to verify insurance details, submit requests, and follow up, which can take 15-20 minutes per request. Denials complicate matters further, increasing administrative burdens and operational costs.
These delays impact patients directly, raising risks of hospitalization and serious health issues. Around 27% of physicians report frequent denials, with many stating the criteria are rarely evidence-based. Despite these challenges, only one in five physicians regularly appeals negative decisions due to lack of time.Innovative solutions like Orbit’s AI-powered prior authorization process automation are emerging to address these issues. By streamlining the prior authorization process, Orbit has helped providers save up to 60% in costs and process authorizations in as little as five minutes. The advantages of automation include improved patient experiences with access to care, reduced errors often made by humans, and significant time savings per physician. Embracing such technological innovations can transform prior authorization into a more efficient system, enhancing patient access to care and overall healthcare outcomes.
Source: Orbit Healthcare