Getting Started With Electronic Prior Authorization EHR Integrations

As healthcare providers are looking for smart ways to mitigate clinician burden, the next frontier for the digital transformation will be streamlining the prior authorization process. Automating prior authorization could result in great healthcare quality and providing patients with their medications on time.

Many healthcare organizations developed their software to accommodate the change, and the process could be more efficient with the integration of an EHR.                                                                                                                            

What is electronic prior authorization?

is a utilization management strategy that payers use to ensure patients access the most cost-effective medication available for their clinical needs.

When a drug has prior authorization requirements, providers must submit certain documents to the payer for permission to prescribe the drug. However, the traditional prior authorization process is time-consuming and can lead to delays in inpatient care.

Electronic prior authorization (ePA) aims to speed up the process by sending prior authorization documents digitally instead of via phone or fax. ePA can be integrated into EHR systems to allow providers to easily request prior authorization within their clinical workflows.

Benefits of electronic prior authorization EHR integration

Traditionally, patients would go to their pharmacy, the pharmacist launching into a series of lengthy calls to see if a prior authorization is required and to get approval if necessary. All that happened while the patient was just waiting.

That leads to patients leaving their recommended course of treatment, worsening their condition, and creating more unnecessary work for providers. It poses an even bigger problem for patients suffering from chronic pain and other conditions that require consistent medications. Thankfully, ePA offers an easier solution, benefiting practices and patients alike.


Real-time Results

Patients suffering from chronic pain need immediate solutions. An electronic Prior Authorization system allows providers to get PA results in real-time. If it’s integrated with an EHR, providers can start the PA process at the point of prescription because it is integrated right into their EHR’s prescription workflow. You may even have the results back before the patient has left the clinic. 

Automated Process

PA requests done in EHRs are automatically populated with the patient’s information and medication data. It saves your staff valuable time in filling out all the necessary fields in the PA form. 

Less Turnaround Time

In an ePA process, requests are sent and received electronically, eliminating numerous phone calls and faxes. Staff can spend less time doing prior authorization work and more on patient care. That rings especially true for pain management clinics where patients suffering from chronic pain need immediate attention and ongoing access to care.

Final Thoughts

Electronic prior authorization could benefit both healthcare providers and patients, but like other health IT innovations, real success can be enjoyed only with proper training. Getting started with prior authorization EHR integration with CapMinds will be the right choice to cut down your clinical burden.

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