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Survey: Docs Frustrated with Manual Prior Authorization Processes

April 26, 2016
by Rajiv Leventhal
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A survey of more than 300 physicians, clinical and administrative staff, and electronic health record (EHR) vendors conducted by Surescripts, the Arlington, Va.-based operator of a national clinical electronic network, revealed that providers are growing frustrated with manual processes around prior authorization.

Although designed to control costs, providers have grown extremely aggravated with the process, spending five to eight hours per week handling these requests when manual processing is the only option, according to Surescripts data. As such, many EHR software systems have incorporated electronic prior authorization capabilities, but the functionality may not yet be a standard option, despite vendor acknowledgment that it can improve clinician workflow and quality of care. Providers noted three key benefits of having access to electronic prior authorization functionality: more efficient workflow, time savings, and reduced administrative burden.

What’s more, when it comes to the inefficiencies of manual prior authorization processing, the survey and other existing research indicated that 80 percent of prior authorization requests require extra work, rework or phone/fax follow ups, and 30 percent of a practice’s incoming calls are from patients looking for their prescriptions.

Indeed, manual processing of prior authorizations is archaic, and physicians and their clinical support staff recognize that making the process electronic is becoming increasingly important and necessary.  Of providers surveyed: 83 percent said that adding electronic prior authorization is a priority, while 64 percent agree or strongly agree that their EHR vendor should provide the functionality to help alleviate the pain points of prior authorization.

EHR vendors recognize the value of having an electronic prior authorization solution as well, with 88 percent citing that they are aware of the importance of this functionality to their customers. Similarly, 86 percent recognize that electronic prior authorization functionality is something that their customers expect their technology to provide in order to help them manage the process.

Regarding the impact on patients, 66 percent of physicians say that it can take two or more days, on average, for patients to get their medication when a prior authorization is involved, and 40 percent of prescriptions are abandoned at the pharmacy due to delays. These delays mean decreased medication adherence and ultimately affect care quality, both of which can be improved when prior authorizations are processed electronically, according to Surescripts.

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