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REPORT

The truth about prior authorization

What payor data reveals about healthcare’s big burden

Cover image for our report on the truth about prior authorization

Is the prior authorization process improving?

No one likes prior authorization. Certainly, doctors and patients have expressed strong disdain for the process, but even payors have taken steps to reduce its frequency. And yet, prior authorization is still very much a part of the American healthcare system.

Payors say they’re taking action to improve the process … but is the process actually improving? What trends can we observe from prior authorization data collected directly from payors? With this report, we’re answering these questions with help from the Infinitus AI agent.

Contents:

  1. Prior authorization (PA): more than just a burden
  2. PA submission
  3. Turnaround time
  4. Notification of determination & site of care
  5. Step therapy requirements
  6. Do renewal processes exist?
  7. Key takeaways

See prior auth data that’s never before been available publicly

This report uncovers details about:

Submission methods

Prior authorization has traditionally held the lowest electronic adoption rate of all administrative transactions in healthcare, but are more payors finally accepting prior authorization requests digitally?

Step therapy

As prior auth use increases, have step therapy – sometimes known as fail first – requirements increased as well?

Turnaround time

According to the American Medical Association, 80% of physicians say prior authorization use has increased over the last five years. Has turnaround time risen along with it?

And more…

Sample pages from The truth about prior authorization, a report from Infinitus
Cover image for our report on the truth about prior authorization

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