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Slide Presentation from the AHRQ 2007 Annual Conference

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Prior Authorization Testing

Text Description is below the image.
  • Prior Authorization test with Anthem; "unsolicited model"
    • Prescriber sees drug-specific questions when drug is picked
      • Celebrex, Mobic, Lyrica, Provigil, Viagra, Nexium, Crestor, Vytorin
    • Answer questions, submit and receive response via OnCallData™
      • PLUS parallel fax-based workflow
  • All UHMP non-pediatric practices, no training!
  • Live 12/10/06
  • 30 transactions over 4 weeks
    • 17 prescribers, 13 practices (25/30 by surrogates)
  • Mean turnaround time for authorizations: 87 min
    • Highly valued
  • Main glitch: 12/30 were "repeats"

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