Christine Migliaro of Northwell Health offers a reality check on prior auth automation, detailing the challenges from ROI and user adoption to the emerging threat of payer "bot blockers."
While technology can help to streamline prior authorization processes, challenges associated with implementation limit what works as plug-and-play solutions. In this episode of HL Shorts, discusses the hidden difficulties of prior auth technology and explains how some payers are actively work to thwart provider automation.
Luke Gale is the revenue cycle editor for HealthLeaders.
KEY TAKEAWAYS
Because many automation tools do not work for all payers, decentralized staff often default to manual processes they can use for everyone, creating a "digital divide."
Some payers are now countering provider automation with "bot blockers," causing previously effective PA technology and workflows to fail.
As health systems operate on very small margins, any investment in automation must be justified by a strong ROI that is clearly understood before purchase.