Electronic Prior Authorizations Impact Quality, Provider Burden

The industry-wide conversation around prior authorizations is complicated and contentious. They are considered useful for preventing adverse health events but also burdensome for providers. As a result, major provider organizations have called on payers to rectify the failures of the prior authorization system.

Among providers who used electronic prior authorization for most of their patients, 54 percent had fewer phone calls, and 58 percent had fewer faxes related to prior authorization. Furthermore, 63 percent spent less time on the phone and around the same amount spent less time on faxes related to prior authorizations.

However, when observing reported trends among the entire provider population, nearly half or more than half stated that there was no change in the volume or time spent on phone calls and faxes when using electronic prior authorizations.