Volume Doubled – Prior Authorization Case Study
The Client
A health plan specializing in State Medicaid business with stringent regulatory requirements was using a manual process to address requests for authorizations, accessing multiple systems to gather decision information and to disseminate results across the organization.

Challenge/Business Need
Complete documentation
Faster processing (24-hour turn-around)
Ability to handle new business
Easier reporting to state agencies
Share the information across the enterprise
Support a dispersed work force
Solution Provided
Paperless processing
Full documentation and audit support
Integrated faxing service
Custom reporting support
Custom work queues
Web-based software support for dispersed work force
Enterprise integration to share request status across the organization
Benefits/Results
Volume doubled with an actual reduction in staff
Processing speed increased more than 133%
Paper case documentation eliminated
State reporting prep time reduced by more than 50%
100% compliance with state processing requirement using custom queues
Customer Service access to request data via their standard system and process
Staff access the system from multiple locations via the web
Schedule Live Demo