An enormous aspect of the patient care experience is the administrative efficiency impacting the healthcare players. These players or stakeholders include the clinicians or physicians, the hospital providers, insurance companies, and the patients themselves.
We know providing healthcare isn’t as simple as a medical professional treating a patient, then the patient pays the doctor. The medical records and electronic health records all must securely pass to each stakeholder for the appropriate actions to be approved — from prescribing medication to billing the patient. All this to say, healthcare IT solutions that improve administrative efficiency by quickly and securely facilitate this sharing of health data and records all come back to improving patient care.
A prominent example of the administrative work that goes into patient care is the process of prior authorization. With prior authorization, it requires a physician to obtain approval from the patient’s health insurance provider before prescribing certain medications or performing a treatment. Basically, checking with the insurance company and getting their approval to carry out specific procedures keeps overall industry costs in check by providing the best care at the lowest price. Furthermore, the insurance company authorizing the medication or operation means they help cover those costs instead of leaving the patient to pay out-of-pocket for it.
Prior authorization offers several benefits, but an inefficient system causes lost time and money, as well as undue patient suffering. Healthcare IT solutions must improve the prior authorization process that affects providers, patients, and payers. Healthcare IT solutions that support secure automation of the data transfer and requests could drastically cut down on time spent waiting on approval and money spent on the best treatment services.
Each player, often the healthcare and insurance providers, has specific standards and regulations to abide by when accessing and sending patient records. As new treatments and medications become available, the prior authorization process needs to adopt these items into their system quickly.
Savings and Better Care
Merely improving the efficiencies of this system will lessen the burden on most administrative departments working to send and receive the appropriate approval. Hospitals and insurance companies will be able to save money by not always having to pay overtime for staff processing these prior authorizations, having the process streamlined by the right healthcare IT solutions. Patients save money in the process because the more efficient system will be able to determine a cost-conscious course of treatment for their given condition.
Running a patient’s care regimen by the insurance company keeps track of any duplicate services and assess whether the procedures, such as taking a particular medication, is even improving the patient’s condition. Throughout all this, patients can better understand the state of their care and what financial responsibilities they are expected to meet. The ideal healthcare IT solution to prior authorization considers keeping the process transparent to the patient and relevant stakeholders, and secure from others.
Healthcare IT Services and Solutions from Audley Consulting Group
The experts at Audley Consulting Group dedicate their passion and work to providing exceptional healthcare-centered IT services to our clients. Our consultants uncover your business needs to tailor an effective information technology solution that is unique to your situation. We proudly serve public and private sector clients in the Washington DC, Maryland, Virginia areas, and beyond. Audley Consulting group has delivered value-added IT services to businesses and government agencies. We can show how our healthcare IT services can benefit you too. To get started, call us at 301-770-6464, or visit our website. Follow us on Facebook, Twitter, and LinkedIn.