Prior authorization is the most costly, time-consuming administrative transaction for providers.¹ At the same time, prior authorizations for everything from prescriptions to screening to treatments are increasing, increasing the burdens on physicians and staff who are stretched thin and focused on delivering patient care and a positive patient experience.

While it’s an unwelcome administrative reality for today’s healthcare and payer system, prior authorizations aren’t going away. That’s why many providers have accepted this fact of life and created manual processes to manage it. Unfortunately, these manual processes require staff to dedicate hours each day calling payers, forcing staff to often endure long wait times and frustrating interactive voice response (IVR) systems throughout the prior authorization process.

But staffing a team to perform prior authorization activities doesn’t simply divert valuable resources away from patients and add to provider costs. It can also delay treatment, cause patients to abandon care altogether and impact clinical outcomes.

Ninety percent of physicians describe the burden associated with prior authorizations as high or extremely high.²

Replace manual processes with automation and virtual agents

Even as prior authorization demands escalate, the process hasn’t dramatically improved. And, with more providers seeking authorization for more services, wait times have increased as callers sit on hold to obtain approvals for care. Physicians and their staff spend two full business days each week (13 hours) completing prior authorizations, according to the American Medical Association (AMA).² The AMA also found that 40% of physicians employ staff who work exclusively on the prior authorization processing.²

There is an alternative to costly, time- and resource-consuming manual processes, though. Practices can adopt virtual agents that leverage AI and can help minimize administrative costs and delays in patient care by automating the prior authorization process.

Physicians and their staff spend two full business days each week (13 hours) completing prior authorizations, according to the American Medical Association.

Automate prior authorizations with the Grace virtual agent

With Gridspace Grace, healthcare providers have a more convenient and cost-effective way to process prior authorizations. A virtual agent that eliminates the need for high-value staff to wait on hold and navigate IVR systems, Grace provides insurers with the information needed to process prior authorizations or can hand off to provider staff to complete the process once a person is on the line. Indistinguishable from a capable human nurse or administrator, Grace conforms to the same QA standards and methods as human staff and scales to complete all prior authorization calls on your schedule.

Grace helps providers:

• Reduce delays in care and improve the patient experience.
• Free up clinical and administrative staff to focus on patient care.
• Decrease costs associated with prior authorizations.

Listen to Grace conduct prior authorization with payers here, and discover how Gridspace is pioneering real-time speech infrastructure for healthcare.

A virtual agent that eliminates the need for high-value staff to wait on hold and navigate IVR systems, Grace provides insurers with the information needed to process prior authorizations or can hand off to provider staff to complete the process once a person is on the line.

¹ Council for Affordable Quality Healthcare, Inc., 2019 CAQH Index, 2020.

² American Medical Association, 2021 AMA prior authorization (PA) physician survey, 2022.