The Real Cost Of Delay: ScriptSender And Prior Authorization

Healthcare providers are searching for innovative ways to solve long-standing issues in the delivery of care. Whether incentivized by the government or forced by market conditions, they are understanding now, more than ever, that many traditional methods won’t work to keep healthcare viable.

Models that had been acceptable for years, even decades, are now under the microscope. Are they efficient? Do they improve accuracy? Most importantly, what do they do for patients who now expect more control and choice in their care delivery?

Prior authorization is one such hidebound method. A radiologist cannot usually fulfill orders for advanced imaging from a referrer until approval—prior authorization—has been obtained from the patient’s health insurance plan. Without the prior authorization, reimbursement is denied or delayed. Those health insurance systems engage one of many prior authorization vendors to coordinate requests. The process can require several phone calls between all parties, lots of paperwork, and manual data entry—while the patient waits for days to get scheduled for the exam.

ScriptSender’s mission, demonstrated in its entire solutions portfolio, is to streamline the sharing of data across divergent platforms. ScriptSender makes it easy for data to flow. ScriptSender’s technology reduces the cycle time from days to hours for prior authorization.

ScriptSender customers send data to any platform in a single click, and that’s any data—referrals, orders, clinical notes, insurance information, anything. No complex interface is required. When the order and clinical note are sent with one click, ScriptSender uses its own artificial intelligence engine to determine whether prior authorization is needed for the exam. If it is needed, ScriptSender identifies all the data elements required to secure the prior authorization and sends that information seamlessly for approval of the request.

With no phone calls and faxes back and forth, it’s the right data delivered directly and securely to the right system, regardless of what platform is used. This is technology that delivers on the promise of making workflows faster and easier.

It is estimated that each prior authorization request costs the care provider $3-10, including the indirect costs—the labor that could be re-directed to patient care instead of paperwork. ScriptSender customers have built-in access to this capability, with no extra fees or transaction costs.

Apart from significant savings for the provider, ScriptSender delivers better access to clinical data. Clinical notes from the ordering provider are seemingly held behind a barrier; even with HL7 that information would have to be faxed. With ScriptSender, clinical notes can be securely and instantly shared with the radiologist, the Radiology Benefit Manager, and the insurance provider, so all stakeholders have the most accurate, primary data they need to collaborate on patient care.

Above all is the impact on patients, who no longer have to wait a week or more for appropriate healthcare. By getting data to the doctors that need it, when they need it—quickly and securely—ScriptSender is creating value for the patient that is expecting more.