The Outlook on Electronic Prior Authorization, with special guest April Todd of CAQH
It’s no secret that achieving fully electronic prior authorization is a challenge, but the potential upside is tremendous—to the tune of $454 million in savings, according to the 2019 CAQH Index Report. On today’s show, Andrew Johnson meets with our special guest from CAQH, April Todd, to shed light on areas around prior authorization that remain the most challenging, the benefits of transitioning to an automated workflow, and efforts underway to speed adoption of electronic prior auth. Today’s panelists are Andrew Johnson, vice president of Electronic Prior Authorization Solutions for Change Healthcare, and April Todd, senior vice president for the CAQH, a non-profit alliance creating shared initiatives to streamline the business of healthcare. They unpack: The purpose and role of the CAQH CORE (Committee on Operating Rules for Information Exchange) Why prior authorization is a challenge for payers and providers Update on alignment between industry standards bodies, including CAQH, WEDI, and HL7 Da Vinci Which areas of healthcare are furthest along in adopting electronic prior authorization CAQH’s latest research on the cost of manual versus automated transactions How electronic prior authorization drives better patient care and reduces costs Building blocks of an ideal prior authorization workflow Steps Change Healthcare and CAQH are taking to advance electronic prior authorization How COVID-19 is affecting adoption Timeline for shifting prior authorization into a fully automated process How listeners can support electronic prior authorization advancement Episode Resources April Todd’s bio Andrew Johnson’s bio CAQH website CAQH Index CAQH Core The "Intelligent" 278: Creating a Standard for Shared Decision Support InterQual Connect How InterQual Connect works Automation and Appropriate Care Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare
