Availity, the nation’s largest real-time health information network, and Regence, a family of regional health plans serving members in Oregon, Washington, Idaho and Utah, announced today the results of their collaboration to improve the pre-authorization process through the implementation of new tools that allow for real-time, electronic and automated pre-authorization.
To download a copy of “Adhering to Cost-Effective, Evidence-Based Care Through Improvements to the Pre-Authorization Process,” click here.
The pre-authorization process helps determine coverage of prescribed services or treatments, providing additional oversight to uphold safety, efficacy, quality, and cost-efficiency of care. However, it can be a source of frustration for providers when it causes unnecessary delays of treatment for patients.
Regence and Availity embarked on a pilot program to redesign and improve this process to increase efficiency and reduce providers’ administrative burden. The focus was automating key components throughout the entire pre-authorization process. Read More: Regence