Fort HealthCare automates prior authorizations with 91% success rate

How a high-performing rural community hospital is improving the patient experience while increasing staff engagement

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fort-memorial-hospital
EHR

Cerner

Employees

840

Outpatient visits

228,000

Physicians

55+

The challenge

Before partnering with Notable, Fort HealthCare’s ambulatory surgery center was struggling with mounting prior authorizations – 2X the volume of work compared to staff onsite.

“We were looking to digitize the entire patient journey, so we knew we needed a long term partner,” said Carl Selvick, PharmD, MBA, FACHE, Senior Director, Clinic Operations at Fort HealthCare. "We also had very immediate needs in each of these areas - for example, we had several weeks of prior auths waiting to be submitted which delayed care. In addition, 38% of calls to one of our busiest clinics were going to voicemail, creating a negative feedback loop –patients would end up calling multiple times, resulting in double the work for the same patient.”

Given the importance of processing authorizations to ensure patients can receive timely care and alleviating the heavy burden on staff, Fort HealthCare began their automation journey here.

The solution

To deliver on its commitment to localized, patient-centered care, Fort HealthCare partnered with Notable to improve patient engagement as well reduce administrative burden for staff.

Notable makes it possible for health systems to meet patients where they are – at home or on the go – making it easier for them to register ahead of time, before they arrive in the clinic. This eliminates frustrating experiences for patients like having to wait on hold or in the waiting room, fill out paper forms, or complete information that has already been shared from a previous encounter. By digitizing and automating the registration process, Fort HealthCare has seen more patients successfully complete their registration, reporting a 74% digital completion rate. This has also resulted in a more than 5% reduction in cancellations.

On the backend, Notable works authorization requests for Athena Blue Cross, Humana, United Healthcare, and Dean. This includes submitting and statusing them within payer portals, or with e-faxing the payers. Notable digital assistants read all documentation via optical character recognition (OCR), even if it originates on paper. Then they automatically append the most appropriate documentation for the payer and write the approval back into the EHR.

Today, 91% of prior authorizations submitted through Notable are successful, saving 15 minutes per successful submission. Fort HealthCare went live with automated prior authorizations in just four weeks, and after seeing immediate results, expanded to additional workflows a month later.

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"Notable is much more than a vendor. They are a true partner that complements our mission and vision, which is to improve the health and well-being of the communities we serve. Notable was the first organization that listened to our needs – throughout our initial scoping and implementation discussions, their team would come back to us with new solutions and capabilities that could be readily deployed to solve the challenges unique to our community."

Carl Selvick, PharmD, MBA, FACHE
Senior Director, Clinic Operations

Carl Selvick

Carl Selvick, PharmD, MBA, FACHE
Senior Director, Clinic Operations

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