How Clinect is Changing the Game in the Required Pre-Auth World

Clinect Healthcare’s Impact on Required Pre-Authorizations

The medical industry is constantly evolving. New information provides new technology and with new technology comes enhancements in the medical field. We can all agree that lack of office efficiency is costly and wasteful of vital resources. So, when health insurance companies started to require prior authorizations or prior approvals for certain prescriptions, surgeries, and or procedures, medical professionals were burdened with yet another time-consuming, but necessary task. Insurance companies orchestrated this action plan in an effort to have some type of control of cost. Patients are now required to acquire approval in advanced for certain deliverables in order to qualify for payment coverage by their insurance companies.

Research supports that this new mandatory regulation significantly impacts providers, practices, and most importantly, patients. Prior authorizations are known to be a very time consuming, manual process that wastes valuable resources that could be otherwise focused on patient care. Not to mention, additions in workflow are known to disrupt care, redirect resources from patients in need, and interfere with their medical decision making. In a study organized by the AMA, almost 80% of physicians reported that prior authorizations can sometimes lead to patients abandoning their treatment.

Prior authorizations require automation to help reduce the responsibility of collecting data during the proper cadences required. This is where Patient Reported Outcomes (PROs) surveys and Clinect come into play. Think of PROs as validated measures and screening tools, completed by the patient, that provide a comprehensive and a longitudinal picture of treatment from the patient’s perspective. PROs also give the provider the ability to monitor remote patient progress. This helps ensure patient compliance and provides constant touchpoints throughout the patient journey.  Whether in the practice or at home, patients provide critical feedback to ensure they are on track. Response thresholds provide real-time alerts, which immediately notifies the provider that a patient may or may not be within the normal range of scoring.

As more payers require PRO data prior to authorizing treatment, Clinect PROs will collect, score, and provide the data export to meet these new requirements. With Clinect PROs, you’re now able to automate cadences or utilize our on-demand delivery tool (where you can order PROs in real time). Clinect manages the entire process both automatically, as well as offers “ordering” capability to administer PROs to patients by instantly sending to a patient device or in-house tablet. Pre-Authorizations just got a whole lot easier thanks to the Clinect platform.