The Digital Doc: Exploring Health Tech Innovation

Congress Investigates Prior Authorization Denials from MCOs

Dr Erkeda DeRouen
January 15, 2024

According to the report, MCOs denied an average of one out of every eight prior authorization requests for service 🤯

Do you think that we need prior authorization reform?

This is the bane of existence for many health care professionals, often contributing heavily to burnout.

Here are some digital health organizations that are working on reimagining the prior authorization process:

Transforming UM in Healthcare | Cohere Health®

Cohere Health is transforming utilization management and prior authorization from an inefficient burden into a strategic asset.

coherehealth.com

Health Care Service Corporation (HCSC) | Health Care Service Corporation

www.hcsc.com

Home - Banjo Health - Intelligent Prior Authorization

The Banjo Health platform was designed by clinicians and developers, working side-by-side, to make prior authorization work better for everyone involved. You configure it to your needs, using an intuitive interface, and then put it to work.

www.banjohealth.com

There are so many more popping up, but with some of the recent call outs (and lawsuits) of larger health organizations such as Humana, United Healthcare, and Cigna using AI to deny individuals care, even when they should have qualified , I wonder can the health tech world get it right?!?!?

What are your thoughts?

Let’s schedule a chat at https://calendly.com/drerkeda/1-1-chat-with-dr-erkeda