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For health plans, prior authorization (PA) is an integral part of utilization management driving two of the most important operational factors: cost and quality of care. Organizations across the ecosystem have tried to make the process more automated, but few have found success.
Considering PA’s importance, the slow and manual interventions required by providers, members and health plans in the age of digitization is something that needs urgent scrutiny. And for health plans that position themselves ahead of the curve, there is further potential to invest in advanced analytics that enhance ease of