Simplify complex processes and improve payer-provider collaboration.
Simplify complex processes and improve payer-provider collaboration.
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Streamline workflows, reduce denials, and ensure accurate payments.
Streamline workflows, reduce denials, and ensure accurate payments.
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Seamlessly deliver complete and accurate healthcare information.
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Simplify the prior authorization review process.
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At Availity’s annual Availity Connects conference last May, my colleagues and I participated in a Shark Tank-type event where we each pitched our best product innovation idea for 2022. I’m proud to say that my idea for a digital correspondence hub was the big winner. Connects attendees all loved the idea of a centralized correspondence ecosystem supporting digitized versions of letters that are typically faxed or mailed.
At this year’s Availity Connects I was even prouder to announce the launch of our first payer-to-provider digital correspondence capability—Authorization Letters. Authorizations generate a huge volume of correspondence between health plans and providers, and tackling these letters has the potential for significant savings.
When providers request a prior authorization, health plans must send an authorization determination letter that includes the decision or a request for more information. Not every authorization requires a letter, but when it does the letters tend to be long, averaging about four to seven pages.
We piloted Authorization Letters with one health plan that elected to start with just a subset of the letters they typically mail. The volume for just one month was 66,000. When you factor in postage costs (currently $0.63 for First Class mail), printing, and labor costs, the savings are estimated to be more than a million a year. Those savings are projected to increase as volume increases.
Cost savings alone would make Authorizations Letters well worth the investment, but digitizing these letters will also help streamline the authorization process. Too often, providers and members are stuck waiting for the determination letter that may be lost in a hospital mailroom.
How does Authorization Letters digital delivery work? First, Availity establishes an API connection with the health plan. As letters are available, the health plan notifies Availity, and we make an API call to retrieve them and display them within Availity Essentials. When providers log in to the Authorizations Dashboard in Essentials, they see a notification that a letter is available and can then download the letter as a PDF. Because Availity can report when a document has been opened, health plans have visibility into its delivery.
If you are an existing Availity customer and want to learn more about Authorization Letters, contact your account manager. To learn more about our full suite of payer solutions, click here!