Digital Transformation of Prior Authorization (PA) from Providers to Payer and to the Patient
Mesh Health Solutions, a healthcare information technology company with over 30 years of combined utilization management experience, sought to address the challenges of medical prior authorization (mPA) for health plans. Their goal was to create a seamless system for sharing information among providers, health plans, members, medical equipment suppliers, and other healthcare vendors.
Challenge
Mesh Health Solutions aimed to streamline the prior authorization process to enhance decision-making and reduce delays in care for members.
Complex Information Sharing
Inefficiencies in Current Systems
Solution
Entrans developed a comprehensive solution designed to integrate seamlessly with existing payer software and automate prior authorization processes.
Result: Mesh successfully bridged the gap in the digital transformation of prior authorization, enabling standard information exchange between payers and providers about member care.
Detailed Solution:
- Seamless Integration: integrate with the existing software of payers, ensuring that all relevant information could be easily shared and accessed by different stakeholders in the healthcare ecosystem.
- Smart Filtering and Automation: The system employed smart filtering and automation to process information quickly and accurately, reducing the manual workload and minimizing errors.
- Future Proofing: The solution was built with future scalability in mind, ensuring that it could adapt to evolving needs and technologies in the healthcare industry.
Impact: The implementation led to significant improvements in the efficiency and accuracy of prior authorization processes. The user-friendly UI provided a single tracker with all the necessary details, allowing for streamlined communication and decision-making.
Outcomes
Enhanced decision-making by integrating diverse data sources and automating processes.
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Reduced delays in member care through efficient and accurate information sharing.
Improved user experience with a simple and attractive UI.
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