Challenges of ePA
Payers
- Struggling to meet CMS and State turnaround time requirements
- 73% PAs submitted using manual process (CAQH 2021)
- Incomplete data for approving request
Providers
- 88% cited Prior Auth as major burden
- Time consuming (spends 2 days/week)
- 93% reported PA caused care delays (AMA 2021 PA Survey)
Patients
- Life threatening delays in care
- Lack of transparency
- Major source of dissatisfaction
Cost
- 90% of manually reviewed requests are ultimately approved
- Duplicative effort between providers and payers
- Unnecessary PAs submitted create noise and overhead
- ML opportunities based on historical PAs by provider
The Solution
ZeOmega’s HealthUnity Smart Authorization Gateway is your answer to reducing prior authorization friction. The solution lowers burden by creating an end-to-end, FHIR®-enabled workflow for submitting electronic prior authorization (ePA) requests directly from the providers’ EMRs to payers, which in turn facilitates immediate decisions.
The HealthUnity Smart Authorization Gateway saves time, lowers costs, and reduces delays in patient care.
