Integrating Prior Authorization Into Clinical Workflows for Care Access and Practitioner Experience

Is clinically integrated prior-authorization software associated with improved transparency, reduced administrative burden, and improved patient access to care?In this quality improvement study of 6551 cases from a radiation oncology patient population, implementation of a clinically integrated prior-authorization system in a multicenter radiation oncology practice was associated with a statistically significant 65% mean reduction in denial rates, a 34% decrease in median authorization times, and improved staff satisfaction.The findings of this study suggest that real-time transparency at the point of care may enhance patient outcomes with streamlined workflows, reduced costs, and improved timely access to radiation therapy.

Corresponding Author: William C. Chen, MD, Northwell Health, 2000 Marcus Ave, Ste 300, New Hyde Park, NY 11042-1069 (williamchen79@gmail.com).

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