We saw significant market forces emerge or continue to develop in 2022 that will dramatically affect prior authorization. Here are five that we see as particularly important:
1. New regulatory requirements, both state and federal, are driving forward-thinking health plans to employ intelligent prior authorization solutions.
2. The transformation of intake channels from fax and other manual, disjointed sources promises to reduce the administrative burden of prior authorization.
3. Clinical interoperability from native EMR prior authorization intake is growing, which will shorten TATs, unify provider experience, and increase transparency.
4. Green lighting, a more targeted alternative to gold carding, speeds or eliminates prior authorization for providers who meet specific quality standards.
5. Administrative and clinical nudges are emerging as an AI-driven innovation to further improve provider experience and drive better, faster care.
Take a deeper look at these five disrupting trends shaking up the prior authorization status quo in this article. Stay tuned for 2023 trends in intelligent prior authorization transformation, pre-submission influence, and more.
