Anyone in the medical field knows that prior authorizations are an issue. A 2023 survey of physicians by the American Medical Association (AMA) speaks to the "devastating outcomes" the PA process continues to have:
- 93% of physicians believe that the PA process has a significant negative impact on patient clinical outcomes.
- 1 in 4 physicians reported patient adverse events that trace directly to prior authorization, including hospitalization, permanent impairment, and death.
- Over 60% of physicians claim prior authorizations require ineffective initial treatments that cause delays in care and increase the burden on overbooked providers.
As difficult and burdensome as the prior authorization process can be, it's our industry's necessary evil. We must beg the question:
With patient care on the line, should we have alternatives to our PA processing? What if, one day, it all came to a halt?
The risk of a single prior authorization processing tool
This is one of the scariest issues looming in the prior authorization space: if your favorite pharmacy ePA prior authorization processing tool goes down, what happens to your prior authorization process?
For most healthcare providers and pharmacies, the answer is that prior authorization processing would grind to a crawl… or stop altogether. In addition, of the over 60,000 pharmacies mapped across the United States, over 70% of them rely on a single PA processing platform.
In the event of a shift, the cost to our organizations, colleagues, and patients could be catastrophic.
Creating your PA processing backup plan
Having a PA processing backup plan is crucial for pharmacies and hospitals to ensure uninterrupted patient care. Without an effective PA tool, the approval process for medications and treatments can be significantly delayed; having a Plan B ensures there is an alternative system or manual process in place to pick up the pieces.
This preparedness reinforces your organization's resilience against technological failures or changes - enabling you to minimize interruptions, keep the burden off of your team, and maintain PA workflows.
Our recommendation when developing a Plan B for your PA processing is to focus on tools that integrate well with your existing systems and keep the burden off your team as much as possible.
Exploring UltraTouch Verify - your ePA alternative
UltraTouch Verify is standing by as your alternative to traditional ePA. UltraTouch Verify not only provides a smarter way for your pharmacy or hospital system to process pharmacy prior authorizations but functions as a seamless backup to your existing system.
UltraTouch Verify offers:
- IT support and simple transition services. Verify & the D2 team have simplified migration processes, making it easy for you and your IT team to migrate from an existing ePA platform to Verify in the event of a sudden change.
- White-glove PA processing support. More than 2/5 of physicians have staff working exclusively on prior authorizations - what happens if these teams become reliant on manual processing? Or if there's turnover? Verify's E-Services team is available on a per diem basis to cover your new and existing PAs until staff can step in again.
- PA Insights™ integration. Amidst the ever-changing and opaque PA requirements, Verify provides transparency into what is needed for your PAs. Verify's newest feature, PA Insights, is a system that grows over time by analyzing your PAs and offering inline intelligence as you process them. Learn more about PA Insights here.
- Verify doesn’t rely on traditional ePA, so it isn’t limited to the processes determined by payers that delay care and slow down the prior authorization process (ex. hidden step therapy, criteria that leads to follow-up questions or denials, etc.). Verify asks for the information needed upfront and delivers the information to payers to ensure they have all the information needed to make a determination.
What would you like to know about UltraTouch Verify?
As a team of former pharmacists and healthcare leaders, our mission at D2 Solutions is to help you increase efficiency, minimize risk, and drive access so you can focus on what matters most: providing the best care to your patients.
Let us know what PA management & processing challenges your organization is facing - we're here to jump in and help you bridge the gap.
