Prior authorization

XIFIN Enhances Prior Authorization and Appeals Automation Capabilities to Improve Reimbursement for Diagnostic Providers

Retrieved on:

Tuesday, November 19, 2019

Data management, Medical Supplies, Practice Management, Technology, Professional services, Health, Medical devices, Software, Hospitals, Internet, Insurance, Information technology management, Articles, Business, Business process management, Workflow, Prior authorization, Infinx Healthcare, XIFIN, Inc.

The Infinx prior authorization software is a cloud-based solution driven by AI and automation, and human expertise to deliver a best-in-class approach to patient access.

Key Points:

The Infinx prior authorization software is a cloud-based solution driven by AI and automation, and human expertise to deliver a best-in-class approach to patient access.
The integration of technology and certified prior authorization specialists gives providers complete coverage of their prior authorization workflow from determination, initiation, status follow-up, through to verification of each authorization.
By integrating our software with XIFIN RPM, our technologies will address a huge reimbursement bottleneck by automating the prior authorization workflow.
By expanding our capabilities and partners, we provide our customers with the automation options they need to improve their prior authorization processes, lower costs and reduce related denials.

Virtue Technologies and Myndshft Announce Partnership to Accelerate Time to Therapy for Infusion & Specialty Pharmacies

Retrieved on:

Tuesday, November 12, 2019

Health, Articles, Specialty drugs, Health insurance in the United States, Healthcare in the United States, Managed care, Prior authorization, Utilization management, Specialty pharmacy, Pharmacy

MESA, Ariz. and MURFREESBORO, Tenn., Nov. 12, 2019 /PRNewswire/ --Myndshft Technologies, a leading provider of real-time benefit check and prior authorization technology for home infusion and specialty pharmacy today announced a partnership with post-acute healthcare technology solutions provider Virtue Technologies.

Key Points:

MESA, Ariz. and MURFREESBORO, Tenn., Nov. 12, 2019 /PRNewswire/ --Myndshft Technologies, a leading provider of real-time benefit check and prior authorization technology for home infusion and specialty pharmacy today announced a partnership with post-acute healthcare technology solutions provider Virtue Technologies.
The partnership will enable infusion and specialty pharmacies to improve patient and physician satisfaction, increase staff efficiency, and reduce the risk of payment denials.
Specialty and home infusion pharmacies are under increasingpressure due to intensifying payer scrutiny of utilization management, and growing demands from providers and patients for detailed benefits coverage and out-of-pocket costs at the point of care.
The Myndshft-Virtue Technologies partnership brings together deep industry expertise and advanced technologies to tackle these challenges by improvingtransparency and accelerating time to care.

RPA Vendor Recondo Technology Tapped by Epic Provider Community to Automate Entire Prior Authorization Process

Retrieved on:

Tuesday, November 12, 2019

Articles, Business, Economy, Business software, Computer access control, Information technology management, Information economy, Prior authorization, Business process automation, Authorization, Business process management, Epic

Health systems are reaping the benefits of integrating revenue cycle content directly into Epic, removing the need for a "bolt-on" third-party application.

Key Points:

Health systems are reaping the benefits of integrating revenue cycle content directly into Epic, removing the need for a "bolt-on" third-party application.
Recently, even Congress has looked into the prior authorization requirements beleaguering hospitals across the country, urged by medical associations to take legislative action on the issue.
These are all capabilities offered by Recondo's Auth-DP, which automates prior authorization transactions within Epic and other systems at a fraction of the time it takes to manually process prior authorizations.
She continued, "While robotic process automation alone is saving millions of dollars in labor costs and denied claims, because Recondo can automate prior authorization transactions directly within Epic, we're also helping hospitals leverage what is often their most expensive technology investment."

Dr. Jeremy Friese of Verata Health Invited to Discuss the State of Prior Authorizations with Minnesota Hospital Association and North Memorial Health Leadership

Retrieved on:

Wednesday, November 6, 2019

Health insurance in the United States, Healthcare in the United States, Managed care, Prior authorization, Medicine, Verata

Joe Schindler, VP of Finance of Minnesota Hospital Association, will moderate the webinar to be held on Wednesday, November 6 at noon CST.

Key Points:

Joe Schindler, VP of Finance of Minnesota Hospital Association, will moderate the webinar to be held on Wednesday, November 6 at noon CST.
Manual, time-consuming prior authorizations are a major bottleneck for medical care, leading to delays in obtaining necessary tests and procedures for patients.
In recent years, errors in prior authorizations have grown to account for 30% of all provider write-offs.
Verata Health is a Minnesota-based, physician-led company changing the way medical practices and hospitals tackle the challenges presented by obtaining prior authorization (PA).

DataFile Technologies Announces Full Market Release of Prior Authorization Services

Retrieved on:

Wednesday, August 28, 2019

Health insurance in the United States, Healthcare in the United States, Managed care, Prior authorization

SHAWNEE, Kan., Aug. 28, 2019 /PRNewswire-PRWeb/ --DataFile Technologies is announcing the full market release of its Prior Authorization (PA) services for healthcare organizations and medical practices.

Key Points:

SHAWNEE, Kan., Aug. 28, 2019 /PRNewswire-PRWeb/ --DataFile Technologies is announcing the full market release of its Prior Authorization (PA) services for healthcare organizations and medical practices.
As a healthcare back-office services and data services company, DataFile already had the elements in place to handle PA processes, including medications, diagnostics, injectables and in-office procedures such as colonoscopies and EGDs.
DataFile adds prior authorization to an established suite of concierge health information management (HIM) services , including release of information fulfillment, chart data abstraction and filing and payer review support plus data access solutions like its Velocity Exchange TM.
(2) DataFile Technologies Customer Survey, Dec 2018
(3) Peckham, C., 2018.

Healthcare providers save time and costs with new integrated product from AIM Specialty Health

Retrieved on:

Tuesday, August 27, 2019

Data management, Technology, Professional services, General Health, Health, Healthcare reform, Insurance, Public policy, Government, Health, Articles, Healthcare in the United States, Health insurance in the United States, Managed care, Prior authorization

AIM Inform , a solution from AIM Specialty Health, integrates with EMR systems to streamline a providers workflow, whether to comply with a health plans prior authorization requirements or to meet CMS criteria.

Key Points:

AIM Inform , a solution from AIM Specialty Health, integrates with EMR systems to streamline a providers workflow, whether to comply with a health plans prior authorization requirements or to meet CMS criteria.
The product facilitates provider access to prior authorization programs operated by AIM for its health plan clients in all 50 states.
By integrating prior authorization and clinical decision-making, we continue to support the provider-patient relationship, said Kevin McDermott, vice president of provider strategy and products at AIM Specialty Health.
AIM Specialty Health provides clinical solutions that drive appropriate, safe, and affordable care.

Waystar Acquires Digitize.AI to Automate Prior Authorization

Retrieved on:

Wednesday, July 10, 2019

Health insurance in the United States, Healthcare in the United States, Managed care, Prior authorization, Information technology management, Business process management

Digitize.AI leverages the power of artificial intelligence and machine learning to automate prior authorizations, resulting in faster authorizations, at less cost, and with fewer denials.

Key Points:

Digitize.AI leverages the power of artificial intelligence and machine learning to automate prior authorizations, resulting in faster authorizations, at less cost, and with fewer denials.
"Providers today are overwhelmed with manual processes related to addressing prior authorization, and it's one of our clients' biggest challenges," said Matt Hawkins, Waystar CEO.
"Digitize.AI is taking a truly different view with trailblazing technology, automating prior authorizations with better results than legacy solutions.
Founded in 2017, Digitize.AI differs from competitive prior authorization solutions by leveraging AI to make smarter decisions.

Molina Healthcare of California Announces Easing of Prior Authorization Requirements in Response to Earthquake State of Emergency

Retrieved on:

Tuesday, July 9, 2019

In the wake of the recent Ridgecrest earthquakes and the state of emergency declared by California Governor Gavin Newsom, Molina Healthcare of California (Molina) has immediately removed barriers to care for affected members.

Key Points:

In the wake of the recent Ridgecrest earthquakes and the state of emergency declared by California Governor Gavin Newsom, Molina Healthcare of California (Molina) has immediately removed barriers to care for affected members.
This includes allowing for emergency prescription fills and easing prior authorization requirements for use of non-network providers in the areas included in the state of emergency declaration.
We will continue to ease the requirements around prior authorization status until the state of emergency has been lifted.
Molina members and providers affected by the earthquake can call one of the following numbers for more information:
About Molina Healthcare of California:
Molina Healthcare of California has been providing government-funded care for low-income individuals for over 35 years.

AMCP Partnership Forum on Prior Authorization Develops Recommendations to Improve Process

Retrieved on:

Wednesday, July 3, 2019

Health insurance in the United States, Healthcare in the United States, Managed care, Prior authorization

While prior authorizations have been used successfully for decades, the process has come under scrutiny in recent years, and many stakeholders have called for improving the way prior authorizations are carried out.

Key Points:

While prior authorizations have been used successfully for decades, the process has come under scrutiny in recent years, and many stakeholders have called for improving the way prior authorizations are carried out.
"AMCP wants to take a proactive approach in addressing recent concerns around prior authorization," said AMCP CEO Susan A. Cantrell, RPh, CAE.
"This Forum will result in recommendations that will allow stakeholders throughout the health care system to enhance efficiencies and decrease burdens when seeking these authorizations.
The Partnership Forum is the latest in AMCP's efforts to make prior authorizations more efficient.

MHK Selects Surescripts to Improve Efficiency Around Electronic Prior Authorizations

Retrieved on:

Tuesday, June 25, 2019

Health in the United States, Health, Healthcare in the United States, Surescripts, Prior authorization, SCRIPT

TAMPA, Fla., June 25, 2019 /PRNewswire/ -- MHK (formerly MedHOK Medical House of Knowledge) is proud to announce that the Surescripts Electronic Prior Authorization solution is now integrated with the MHK CareProminence platform.

Key Points:

TAMPA, Fla., June 25, 2019 /PRNewswire/ -- MHK (formerly MedHOK Medical House of Knowledge) is proud to announce that the Surescripts Electronic Prior Authorization solution is now integrated with the MHK CareProminence platform.
Together, MHK and Surescripts provide real-time integration of two industry-leading solutions to significantly improve efficiencies for health plans managing pharmacy benefits.
Surescripts Electronic Prior Authorization integrates directly with EHRs, enabling healthcare professionals to easily obtain prior authorizations in real time at the point of care.
The Surescripts Prior Authorization Portal provides a free, online way to easily submit fully electronic prior authorization requests right away, even if the service is not yet available within a provider's EHR.