Surescripts' Prior Authorization solutions streamline the traditionally cumbersome medication prior authorization process by integrating automated workflows directly into electronic health records . This integration reduces administrative burdens, accelerates approval times, and enhances patient care by minimizing delays in medication access.
Key Features and Functionality:
- Touchless Prior Authorization: Automatically retrieves necessary clinical data from the patient's EHR and transmits it to the pharmacy benefit manager . If all criteria are met, approvals can be granted without human intervention, significantly reducing processing times.
- Electronic Prior Authorization : Allows healthcare providers to submit and manage prior authorization requests directly within their EHR workflow, eliminating the need for paper forms, faxes, and phone calls.
- Prior Authorization Portal: A free, web-based platform enabling prescribers and their staff to submit and manage prior authorization requests online, even if their EHR does not support integrated ePA.
Primary Value and Problem Solved:
Surescripts' Prior Authorization solutions address the inefficiencies and delays associated with manual prior authorization processes. By automating and integrating these workflows into existing EHR systems, they reduce administrative workload, decrease approval times, and improve patient outcomes by ensuring timely access to necessary medications. For instance, Touchless Prior Authorization has achieved average approval times of 30 seconds to 3 minutes and reduced appeals by 88% for in-scope medications.