Healthation to Offer Automated Real Time Pharmacy Pre-Authorization Solution
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DARIEN, Ill., March 5 /- Darien, Ill.-based Healthation announced the release of an automated real-time pharmacy pre-authorization solution for healthcare payers and PBMs, based on its flagship AcceleHealth® benefit management system. The solution will integrate with a payer's core medical and pharmacy systems through its Web services architecture to auto- adjudicate pre-authorization requests using sophisticated user definable eligibility, benefit, clinical step therapy and workflow rules. The company sees real-time pre-authorization processing as an example of how retail-like healthcare should work.
According to Scott Kornhauser, Healthation CEO, the biggest challenge to realizing the promise of industry transformation is integrating the new business transactions that will come to define a retail-like healthcare system.
"Consumerism in healthcare isn't about buying products and services or managing HSAs over the Web. It's about integrating multiple business transactions and multi-dimensional processes that make up a healthcare encounter," said Kornhauser.
By building the real-time authorization solution atop the Web services architecture of Healthation's AcceleHealth® platform, the company is delivering a complete end-to-end benefit management system that is deployed granularly. Further, because the system supports all lines of business, payers are also able to leverage the user-definable rules engine to support pre- authorization functionality across their dental and medical books of business.
To date, pharmacy pre-authorization has been seen as a way for payers and PBMs to reduce drug costs through utilization and disease management. But for most payers it is a paper-driven process fraught with inefficiency. As healthcare grows increasingly digital and new funding models emerge, Kornhauser believes payers will need to extend adjudication capabilities beyond traditional claims processing in order to remain competitive.
"For example," said Kornhauser, "by treating pre-authorization processing the same as claim processing, utilizing the same complex adjudication logic and then integrating workflow into a real-time response, we give payers new capabilities for effecting change at the point of service."
About Healthation
Darien, Ill.-based Healthation is a healthcare technology company helping payers and administrators improve business performance with user-driven benefits management and transaction processing solutions. Healthation's goal is to accelerate a retail transformation in healthcare with a real-time, open exchange platform. The company's AcceleHealth® solution is the industry's only 100 percent Web-based payer system built to administer benefits across all lines of business including dental, medical, vision, AD&D, life and pharmacy.
Source: Healthation
CONTACT:
Mark J. Moticik for Healthation,
+1-630-324-8804,
mmoticik@healthation.com
Web site: http://www.healthation.com/
