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Would you like to know more about Electronic Prior Authorization? EPA can make your PA systems more efficient, reduce the time between a request for prior authorization and a decision, and reduce liability. Although Electronic Health Record systems (EHR) are growing, most medication prior authorizations are still processed manually.
In this article, we’re going to take a closer look at:
What is Electronic Prior Authorization?
In a nutshell, Electronic Prior Authorization (ePA) offers a direct, fast route for prescriptions from the physician, the pharmacist, and the Patient.
Electronic PA requires PBM and EHR connectivity to provide real-time PA responses on patient eligibility and prescription approvals. To date, 85% of covered lives are connected to CompletEPAAccording to the CompletEPA White Paper
How Does it Work?
EPA simplifies the manual PA process as an integrated part of the EHR workflow. Instead of using the time-consuming traditional PA process, the e-prescribing process is much simpler and faster. The physician is notified of any PA requirements during e-prescribing and can choose an alternative medication. The clean prescription is sent through to the pharmacy to fill, and the Patient then picks up the prescription.
How Does Electronic Prior Authorization Differ from the Traditional Prior Authorization Process?
Traditional PA processes are a time-consuming burden, as well as being frustrating. In traditional PA, the physician sends a prescription to the Patient’s chosen pharmacy. The pharmacist then learns that the medication needs prior authorization. The pharmacist must then tell the Patient of the PA requirement and starts the PA request by phone or fax.
The provider and PBM then exchange calls or faxes, and there’s lots of form filling involved. It can take days or weeks for the PBM to grant the PA request, and then the Patient can finally pick up their medication.
With ePA, instead of calls and forms, there is the electronic transmission of information to determine whether or not the PA is granted. There’s much less delay than the traditional PA system.
In fact, according to Healthcare Innovation’s article,” Electronic Prior Authorization Benefits Proven, Yet Provider Adoption Lags,” ‘62 percent of PA requests submitted electronically receive a determination in less than two hours, compared to 0% of PA requests completed via the phone and fax method’.
How Does it Benefit a Provider and Their Workflow?
There are multiple ways that ePA adds value to the e-prescribing process. These include:
● Less administrative burden
● Can give a competitive advantage
● Improved transparency of PA requirements for providers who implement ePA
According to the article from Surescripts, New Analysis Shows Benefits of Electronic Prior Authorization for Patients and Providers (source: AHIP), The AHIP study “found that 71% of experienced providers who implemented ePA reported faster time to patient care. Also, ePA reduced the time between submitting a prior authorization request and receiving a decision from the health plan by 69%.”
Patient Benefits of ePA
The most significant benefit of ePA to the Patient is reducing waiting time where a PA is needed. In turn, this leads to less frustration and more customer satisfaction with their healthcare provider. More Benefits
Also Read – The Benefits Of E-Prescription For Care Delivery
How PrognoCIS Helps to Accomplish this
ePA is the future of Prior Authorization, and it’s just one of how PrognoCIS can help physicians accomplish a more efficient and cost-effective workflow.
PrognoCIS provides customizable templates for physicians to adjust their workflow to meet their specific requirements and needs. PrognoCIS offers dynamic features like Patient Portal, Medical Billing, RCM, and e-prescription to streamline and make such tasks more manageable.