AI-enabled prior authorization solution awarded for helping payers and providers improve the patient experience.
Olive, the automation company creating the Internet of Healthcare, announced today that KLAS awarded Olive with its Points of Light recognition for automating the prior authorization process in collaboration with Essentia Health and a leading health insurance company in Florida. The payer and provider perspectives were featured in a collaborative case study presented at the KLAS Payer/Provider Summit 2022 and demonstrated how Olive’s technology can reduce administrative friction for both providers and payers without requiring direct collaboration or contracting.
The case study is one of 14 highlighted in the annual Points of Light awards that celebrate success stories — or “points of light” — from payers, providers and vendors who have partnered to reduce costs and inefficiencies and improve the patient experience. The 2022 Points of Light award winners fall into six overarching categories. While the most common challenges tackled by the award winners were related to prior authorization or value-based care, Olive’s solution was the only technology in the prior authorization category recognized for improving inefficiencies for both payers and providers.
Both Essentia and the payer collaborator saw measurable improvements in their prior authorization processes. Using Olive’s AI technology, the payer collaborator now delivers decisions to all its providers 48% faster, and they have decreased the number of unnecessary prior authorizations they process by 27%. These results mean that patients have more clarity about the next steps of their care plan and know sooner whether their insurance has approved a test or procedure.
Essentia saw a 30% increase in staff efficiency and a 75% reduction in peer-to-peer reviews. Medical coverage guidelines are automatically pulled for 80% of Essentia Health’s payers and their turnaround time for prior authorizations has been reduced by four to five days.
“Olive has helped us lift an administrative burden off the shoulders of our workforce,” said Melanie Wilson, senior vice president, revenue services at Essentia Health. “Olive’s contribution to prior authorization workflows helped us increase patient access by reducing turnaround time for final status.”
KLAS rated the success achieved in this case study as being “highly replicable” by other organizations. The prior authorization solution utilized by both collaborators is available to all payers and providers in the Olive Library.
“Olive is dedicated to solving the challenge of prior authorizations on both sides of the fax machine,” said Jeremy Friese, MD, president, payer market at Olive. “We’re honored to receive this recognition for demonstrating how both payers and providers achieve great results independently when we improve the efficiency of the prior authorization process.”