In previous SPA blogs and podcasts, we have addressed patient and physician perspectives on the current group benefit private PA process, sometimes called special authorization.
PA is typically used by insurers as a manual claim submission and review process for high-cost speciality or high-utilization prescription drugs. Stakeholders involved in the PA process report that the administrative burden of the current manual PA process is time consuming and inefficient, delaying patient access to prescribed medication.
The PA process is growing increasingly complex. The list of drugs is growing, each payer has their own claim forms for PA, and there is no coordinated workflow process for payers and PA stakeholders. Provincial health ministries are moving online, and it is overdue for private payers to do the same.
The Simplify Prior Authorization (SPA) initiative was launched in November 2020 following the release of the white paper on prior authorization by Connex Health and the Pangaea Group. The initiative is committed to developing electronic prior authorization (ePA) and other solutions that will improve the access process for patients and the user experience for PA stakeholders, including payers. SPA has attracted some payers and many other PA stakeholders who are willing to work collaboratively on an agnostic industry solution to improve the process.
We can and we must do better. When we do, we all benefit.
You can direct questions, comments and inquiries to info@simplifypriorauth.ca.
Read our new article in the May edition of the Benefits and Pension Monitor magazine, where we explore the history of prior authorization, specialty drug spend, new technologies and solutions to advance prior authorization.
Do you or your clients have specialty drug claims on group benefit plans? If so, you need to read this blog and find out about the new patient information and resources website.
The Simplify Prior Authorization (SPA) initiative recently hosted its first webinar in 2023 for group benefits stakeholders on new prior authorization (PA) resources and solutions. Interest was high, with the largest registration numbers since the initiative began.
The Simplify Prior Authorization initiative is an advocate for education about prior authorization (PA) and improvement in current prior authorization practices and processes. If your organization is interested in finding out more, getting involved, or in sponsorship of this important initiative, please contact us via the link below.
