DENT Neurologic Institute, one of the most comprehensive neurologic centers in the U.S.
As they continued to scale, DENT Neurologic Institute needed a more comprehensive and efficient solution to mitigate the administrative burden associated with prior authorizations. Given their size — DENT has a large percent of staff working on prior authorizations across various clinics — along with the growing complexity of dealing with many payers each with their own unique policies, managing this process was segmented and increasingly challenging. That cumbersome process led to slower payer turnaround times, frequent out-of-state denials and preventable interruptions in the provision of patient care.
DENT employed SamaCare’s prior authorization management software to automate prior authorization workflows, and centralize billing across multiple specialties, services, providers, locations and users in a unified, web-based platform.
Within the first 3 months of using SamaCare, DENT Neurologic Institute successfully expanded SamaCare to several clinic teams resulting in a 70% increase in drug authorization volume and:
DENT Neurologic Institute is currently among the largest outpatient neurology practice in the US with 70+ providers and 16 subspecialty clinics each focusing on specific and complex disease states. As a whole, on average the organization schedules more than 1,100 appointments per day and it is estimated that at least 95% require prior authorization as part of the treatment plan. To keep up with continued expansion, the DENT team needed a better way to manage the administrative burden associated with prior authorizations across multiple specialties, services, clinic teams, locations and payers. Moreover, DENT’s commitment to delivering top quality clinical service both within their immediate Western New York community and beyond also contributed to an increasingly convoluted payer mix, as many out-of-area patients specifically seek out DENT for their care needs.
Each of DENT Neurologic Institute’s 16 clinics has dedicated staff to work on prior authorizations as they are organized by specific and complex disease states. This culminated in highly variable and segmented processes throughout the organization, and ensuing challenges included:
The lack of a unified infrastructure and visibility into data analytics and reporting on important metrics such as prior authorization resolution outcomes, and how they differ by service, payer/plan, clinic, and other factors, further amplified these challenges and added to the difficulties experienced by the individual clinics. DENT needed a way to centralize all authorizations and streamline submission, tracking and management for all their clinics and users.
DENT Neurologic Institute chose to partner with SamaCare to optimize their prior authorization workflows, and consolidate all activity in a uniform and all-inclusive web-based platform. Built-in data analytics ensures access to real-time utilization and speed metrics to measure team productivity, identify missed opportunities and assess payer behavior. SamaCare’s advanced functionality also enables DENT to exercise more control over new patient volume through management of outside referrals, in addition to authorizations.
Implementing SamaCare at DENT clinics was fast and simple, since SamaCare does not require technical integration with existing practice software. The DENT team was able to onboard clinics onto the platform and go live within 2 weeks, faster than initially planned. Upon launch, the team was able to utilize the platform and see results the very same day, especially in their infusion centers.
A way to centralize all prior authorization submissions, tracking, and management across all of their clinics.
One centralize, web-based hub for submitting, tracking, and following up on prior authorizations.
Insight into prior authorization outcomes, and how they differ by service, payer/plan, clinic, and other factors.
Customizable data and analytics to track and optimize the performance metrics that matter to DENT.
A way to centralize all prior authorization submissions, tracking, and management across all of their clinics.
One centralize, web-based hub for submitting, tracking, and following up on prior authorizations.
Insight into prior authorization outcomes, and how they differ by service, payer/plan, clinic, and other factors.
Customizable data and analytics to track and optimize the performance metrics that matter to DENT.
SamaCare’s robotic process automation (RPA) allow DENT users to reduce time spent on submitting, tracking, and following up on authorizations by eliminating the mundane and repetitive aspects of the process, thereby also reducing the likelihood of 1) human error and 2) consequent processing delays and denials from payers. This, in combination with support from SamaCare’s dedicated customer team, resulted in a 42% decrease in time to resolution and 22% decrease in denials for both in-state and out-of-state insurance authorizations.
“I absolutely love SamaCare. It's made my process SO much quicker and easier. I had a couple of hiccups that were errors on the insurance company's end, and their chat support team was fantastic. The SamaCare Representative resolved my problem by contacting insurance within 24 hours, updated the website with the corrected approval, and personally e-mailed me for detailed follow-up. I've never had a submission portal with such a fantastic provider service experience. Those resolutions were something I potentially could have spent >45 minutes on hold with insurance companies just to resolve.”
— Maeghan Glynn, Prior Authorizations Coordinator at DENT Neurologic Institute Headache Center
The DENT team also gained greater insight into revenue cycle management and navigating prior authorizations past the initial request through SamaCare’s comprehensive platform, thanks to the ability to manage treatment renewals and new referrals from outside providers within a single hub.
“It’s amazing to track everything on one site. Using Samacare has also afforded our infusion center the opportunity to complete the prior authorizations from outside referring offices. Time constraints and staffing were issues that prohibited this for us prior to using SamaCare. This is critical as competing offices offer the service so not only do we have the option now, but in a much more efficient workflow. Once the information is captured in the system, it lives there and is easy to locate. We now spend less time on the phone and more time with patients.”
— Christine Mann, Chief Operating Officer at DENT Neurologic Institute
Furthermore, in working with SamaCare, DENT Neurologic Institute has been able to continue expanding without the need to hire additional staff for prior authorizations, saving on FTE costs in a competitive talent market.
“We have not had to back-fill a PA support position and are still able to complete the PA process more efficiently and quickly. The weekly analytics report is an excellent tool that provides an overview of our activity with important metrics that can become critical for patient care. This is the first program that I have engaged with that works, several have tried over the years but never offering the results like SamaCare.”
— Christine Mann, Chief Operating Officer at DENT Neurologic Institute
“We are living in an era of amazing innovation in neurology therapies for patients, but it doesn’t mean much if doctors and patients are struggling to get through the administrative barriers to using those therapies.”
Get in touch today and we’ll walk you through how SamaCare can help your practice streamline prior authorizations.
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