Administrative overload is pushing health care providers to the brink
Health care providers are under extraordinary pressure. Between rapidly evolving treatment protocols, expanding payer requirements and growing clinical workload, the burdens of modern practice have reached a tipping point. Two-thirds of providers say they feel overwhelmed by the volume of clinical information they must manage. Nearly half of physicians report at least one indicator of burnout, often driven by administrative hassles. And physicians report losing as many as 12 hours per week to manual prior authorization tasks—time that could otherwise be spent on patient care.
Payers are hearing this frustration loud and clear. When providers are buried in paperwork and systems do not communicate or share data, it strains the payer-provider relationship and can delay care for the patients they both serve. The answer isn’t simply working harder—it’s working smarter by connecting the systems providers already use and eliminating the manual steps that create barriers to timely, evidence-based care.
Prior authorization: Where connectivity can make the biggest difference
Among the administrative processes that weigh on providers, prior authorization stands out as one of health care’s clearest opportunities for modernization.
The traditional prior authorization process—while essential to ensuring patients receive appropriate, evidence-based care—has relied heavily on manual, time-consuming steps, including answering medical necessity survey questions and compiling and submitting clinical documentation. Each step takes time and attention away from patient care, which can lead to delayed treatment, patient dissatisfaction and increased provider frustration.
By integrating technology and connectivity, prior authorization can be transformed into a seamless, touchless experience where information flows freely between systems and decisions happen faster.
Enabling care connectivity
Technology-driven care connectivity is built on a simple but powerful idea: transparent, evidence-based care can be delivered with speed and care when systems are designed to work together. By bringing together electronic medical record (EMR) connectivity and automation, modern prior authorization approaches responsibly evolve the medical necessity review process—eliminating barriers to care and reducing the manual inefficiencies that have long defined prior authorization.
A new video shows exactly how this works. When a provider schedules a procedure, the EMR automatically sends information about the scheduled procedure and automatically creates a prior authorization case, eliminating the need for clinical staff to manually enter any information. From there, advanced machine learning can enable real-time approvals of authorization requests with a high likelihood of meeting evidence-based guidelines. For cases that require deeper clinical review, more advanced systems can initiate the automated submission of relevant clinical documentation directly from the EMR, aligning the information with review criteria. This eliminates the back-and-forth of traditional documentation requests and leads to a significant decrease in overall time for clinical decisioning. Throughout the process, providers can check case status in real time directly within their EMR—no extra clicks, no toggling between systems. Information flows seamlessly between the provider’s workflow and the review process, keeping everyone connected and care moving forward.
Raising the bar for transparent, evidence-based care
For health plans, EviCore intelliPath® addresses multiple priorities at once. It supports faster, more streamlined medical necessity determinations. It strengthens provider satisfaction by replacing a persistent source of administrative frustration with a more seamless, connected experience. And by getting patients the right care more quickly, it helps improve member outcomes and experience, and make care more affordable. EviCore approves up to 80% of authorizations in minutes, accelerating access to care. Importantly, automation is never used to deny a case.
Watch the video to see how EviCore intelliPath® works within EMR systems, and how connected, automated technology is creating a faster, simpler prior authorization experience for providers and patients alike.
EviCore intelliPath® is deployed by provider organizations to automate and simplify submitting and tracking requests for prior authorization. intelliPath streamlines operations within a single easy-to-use application that integrates with major electronic health record (EHR) vendors. Provider costs are reduced and decisions are communicated in real time, reducing delays.
