We all know the problem. Your team feels it first hand everyday. Prior authorization volume in the healthcare industry has risen 54% in the last four years. And the problem is only getting worse. More prior authorizations means administrative friction that costs your health organization significantly. Whether you're suffering from frustrated clinicians, unhappy patients that don't follow through with treatments, low labor productivity, or a combination of all three, the prior authorization processes are affecting your bottom line.
Our mission as a company is to reduce the burdens your organization face due to the lengthy, tedious processes used to submit and document prior authorizations. Your employees deserve the opportunity to work at the highest and best use of their skills. We get out of bed in the morning because we believe that by helping with this one widespread problem, we can help you provide the best care to your patients, by the right providers, for the right cost, while also creating a better work environment for your providers and employees.
Lia, our system of intelligence for smarter, faster prior authorizations is the solution to help mitigate your prior authorization burdens. She is the "A.I. Teammate" designed to support your administrative team by using machine learning to seamlessly submit prior authorizations to payers and then deliver the payer response back to your team.
Here are 5 features of Lia that Directors of Revenue Cycle can't live without.
- Lia can work 50 - 70% of the your prior authorization workload. Lia is designed to automatically submit prior authorizations to the payer and then deliver the responses back to your team. Historically, Lia can seamlessly submit 50-70% of the prior authorization workload, leaving the highest level of work for your team. Instead of copying/pasting, and performing manual data entry, your team will work on the cases that require human interaction and inference.
- Lia is not another EHR bolt-on. Lia is not another EHR bolt-on or an additional screen that your team needs to interact with. Between all of the payer portals and multiple financial systems and EMR/EHRs that health organizations have, the last thing we want to do is give your team another application to learn and tab to bounce over to. Lia will operate completely behind the scenes, responding to a clinician prior auth request, gathering the necessary data for that request, submitting to the payer portal, and then returning the payer decision back to the source of your choice.
- Lia works 24/7, 365 behind the scenes. Your team isn't submitting prior authorization requests every minute of every day, they're only human after all. Lia can take over on the nights, weekends, and holidays. Any time a prior authorization request is submitted, Lia will assess that request. With machine learning, she will determine if that request can be submitted without human intervention and submit to the payer.
- Lia produces real-time dashboards. As the Director of Revenue Cycle, you want a holistic view on everything happening in your department. It's no exception to see insight into Lia's performance. As part of Lia integrating with your system, you have a dashboard to see all of your information in one place - approvals, denials, reimbursement for insurance. You can even see how long it takes for payers to deliver an approval to fuel scheduling strategy at your organization.
- Lia gets smarter (and more effective) over time. Payer rules are always changing, which means your team likely struggles to reduce denial rates and acquire authorizations on time (which can lead to appointment rescheduling and a lot of frustrated docs and patients!). But Lia uses machine learning to interpret trends over time and take predictive action to anticipate payer needs i.e. Lia knows how to gather and submit data to payers to preemptively meet their requirements, and can adjust over time as those requirements adjust over time—the outcome is Lia increases authorization rates, reduces denials, and ensures you capture "on time" authorizations. And because Lia "learns" with every new case she submits, Lia offers sustainable intelligence and results.