Integration — and Automation — of Referral and Prior Authorization Workflows Improves Care Transitions
Aidin, a healthcare technology company focusing on care transitions, announced the launch of Aidin PreCert, a prior authorization module on the Aidin platform. Hospitals and health systems can now request, track, collaborate, and report on prior authorizations with health insurers to increase transparency and more efficiently move patients to the next level of care.
Getting health insurers to approve necessary post-acute care is a huge administrative burden for hospitals and community providers, consuming up to 60% of a case manager’s total workload. As prior authorization requests increase due to the growth of Medicare Advantage plans, a private alternative to Medicare, these urgent and sensitive communications often still involve an archaic process of sending faxes to health plans that require tedious attention. The task is further complicated because the discharging hospital and receiving provider are both trying to track authorizations and neither has clear visibility into the other’s actions or status.
With Aidin PreCert, Aidin brings two of the most common case management tasks — referrals and prior authorizations — into one efficient workflow. By integrating and automating these activities, Aidin enables healthcare organizations to minimize costly delays and eliminate manual errors, improving transitions to follow-up care and saving staff time.
Aidin applied the concepts and incentive alignment structures the company created to help hospitals find post-acute placements for their patients. Users create prior authorization requests within Aidin, which distributes the forms to insurers via fax by default, or email or text with aligned health plans. Inbound authorization letters from insurers funnel into the Aidin dashboard and are automatically updated with the latest communications. Users can invite providers to view the requests so all parties can track authorization status.
“Fragmentation is a major problem in healthcare and impacts everyone, especially case managers who are the quarterbacks wrangling insurance companies, providers, families, and doctors,” said Russell Graney, founder and CEO of Aidin. “Aidin PreCert streamlines low-value prior authorization requirements, giving case managers more time to focus on patient care.”