All Pre-Authorizations

How Providers Can Benefit from Efficient Prior Authorization for Infectious Diseases

Prior Authorization for Infectious diseases like HIV, tuberculosis, and malaria are still prevalent worldwide. These infectious illnesses spread quickly and necessitate treatment, and are getting tougher to treat due to antibiotic resistance. According to WHO, deaths due to infectious diseases add to 17% every year globally, indicating the seriousness of such diseases.

However, new treatments and medications including biologics and targeted therapies are growing to be popular in fighting these diseases. Public Health Programs are also rising to ensure faster treatments.

With modern treatments being more expensive and advanced, PA ensures patients attain the maximum and efficient care while handling expenses.

Table of Contents

Challenges Providers Face with Traditional Prior Authorization

Many medical practitioners and healthcare organizations battle with outdated PA workflows that are slow, complex, and frustrating, resulting in delays in patient care.

Administrative Burden:

Providers and their teams spend nearly 14 hours every week filling out forms and waiting for proper approvals.
This takes time away from treating patients and improving patient care.

Treatment Delays:

Approval for treatment for life-threatening diseases like HIV and sepsis often gets stuck in the PA workflows.
For instance, a patient who requires antiretroviral therapy for HIV had to wait weeks as their approval was delayed and it worsened their health condition.

Financial Constraints:

Denied claims indicate the loss of money for hospitals as they need to spend extra for correcting errors.
A slow and dragging process makes doctors less productive and costs rise high.

Benefits of Efficient Prior Authorization for Providers

Updating the PA system can allow doctors to attain quick approvals, enhancing patient care and minimizing stress.

Improved Workflow efficiency:

Automated systems bring in minimized paperwork and reduce approval times by 50%.
For example, Electronic Prior Authorization systems enable request submissions and tracking statuses online.

Faster Access to Treatment:

Through faster approvals, patients attain urgent treatments including antiviral medications and antibiotics without huge delays that could be life-threatening.
Real-life examples include a clinic leveraging digital PA tools that reported faster patient access to care for infectious diseases.

Better Patient Satisfaction:

Patients who attain timely and efficient care are more likely to trust their healthcare provider and minimize hospital stays.
For example, Quick treatment for pneumonia symptoms can eliminate further complications that could turn severe.

Cost Savings:

Providers save ample time and money by minimizing reworks and potential denials.
Clinics that make efficient use of AI-powered systems witnessed a 20% increase in effectiveness, saving resources and time.

How Technology Transforms Prior Authorization for Infectious Diseases

Technology speeds up the PA process, making it more accurate, and less stressful for patients and providers.

Electronic Prior Authorization (ePA):

ePA replaces manual paperwork with digital submissions and tracking.
Approvals happen quickly and most errors are eliminated.
There has been a growth of 40% in the adoption of ePA over the past 5 years.

AI and Predictive Analytics:

AI predicts whether a claim has the potential to be approved, or denied by pointing out any missing details before submission.
Clinics who use AI witness 30% fewer claim rejections as they can correct errors early.

EHR Integration:

EHR and PA process integration links patient medical records directly to the workflow, so providers need not enter the same details multiple times.
New EHR systems now deliver real-time updates on PA status requests.

Data-Driven Decisions:

Analytics tools track the latest trends and insights to help streamline the PA workflows for much faster results.

Key Trends in Prior Authorization for Infectious Diseases

The healthcare realm is constantly evolving, and trends show how PA workflows are getting better to meet the requirements of modern infectious disease care.

Shift to value-based care:

Doctors and hospitals are paid based on the value provided by the healthcare practitioners to the patients rather than the quantity of the services delivered.
For instance, Providers with effective PA management have now improved their approach to patient care as they seem to have enough time away from administrative burdens.

Legislative Updates

Governments are designing policies to make PA more simplified and less time-consuming.
Some new regulations emphasize optimizing PA for specific treatments, like those for infectious life-threatening cases.

Collaboration between insurers and providers

Improved communication and bridging the gap allows effective understanding and therefore reduce delays,
Digital tools enable real-time communication for quick approval rates.

Overcoming Barriers to Adoptions

While new technology helps, some doctors are hesitant due to high cost, and concerns about learning new ways to adapt to the system.

Provider Hesitations:

Many doctors worry that adopting news systems might cost them a fortune and will take so much time to train staff to learn new ways.

Practical Solutions:

A step-by-step guide can aid providers employ effective PA systems with minimum disturbances.

For example, Clinics that followed such steps have reported many easy transformations.

Final Words

Efficient Prior Authorization systems save time, improve patient outcomes, and cut costs through reduced paperwork, timely treatments, reduced errors, and minimized denials.

Partner with Practolytics to ease your PA workflows. Through advanced technology, effective tools, analytics, and a mind for growth, Practolytics ensures faster approvals and improved patient care.

Schedule a demo with us today and find what makes us stand out!