Customer Success Story

Streamlining Prior Authorization Processes to Improve Efficiency and Reduce Costs

Our client, a payer organization in New York that manages Medicaid and Medicare progams, faced challenges with an overworked utilization management staff that struggled to meet turnaround times and minimize provider abrasion due to excessive prior authorization requirements.
Key results included:
  • A streamlined code list was implemented to better align with current industry practices, resulting in the elimination of approximately 16,000 codes that previously required prior authorization.
  • With customized strategies and workflows, we saved the client hundreds of labor hours per month within the Clinical / UM department.
  • By streamlining and improving the prior auth processes at this payer, we were able to improve timely access to care, reduce the volume of prior authorizations and improve provider relations.
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“Impresiv has been an instrumental partner in our journey towards healthcare excellence. Their innovative approach and deep understanding of our goals has significantly enhanced our operational efficiency. Our partnership with Impresiv has not only strengthened our standing in the healthcare sector but has also empowered us to set n ew benchmarks in quality care. We are fortunate to collaborate with such a committed and expert team.”

-Medicaid Managed Long Term Care Plan in New York City