Automated Prior Authorization (PA) Systems
Automate and accelerate claims processing
For state Medicaid programs, manual call center processes can be time-consuming and costly, often negating savings gained by controlling prescribing practices.
Conduent’s Automated Prior Authorization Solutions automate up to 90% of prior authorization (PA) processes. Built on programs’ existing claims processing capabilities, our solutions review member-specific clinical and coverage histories and confirm if prescribed therapies meet current prescribing rules.
We verify PAs for regularly prescribed and specialty medications, as well as non-pharmacy services and equipment in real time, ensuring appropriate therapies are dispensed while using fewer resources from your call center – and your budget.