Humana And athenahealth Expand Electronic Prior Authorization Capabilities Across athenahealth’s Network Of 180K+ Physicians And Clinicians

The collaboration supports Humana’s broader strategy to help patients access care more quickly by requiring prior authorization less often and making it simpler, faster and more connected when it is needed, while reducing administrative work for providers.

Prior authorization builds checks and balances into the healthcare system to ensure that patients receive the right care at the right time. It also helps ensure that care is safe, high-quality and evidence-based. At the same time, prior authorization can add complexity and create frustration for patients and providers. Humana and athenahealth are working to reduce the paperwork, phone calls and manual steps often associated with prior authorization, making the process easier for providers and faster for patients.

Early indicators show the potential to reduce administrative work for physician practices. By helping identify and exchange needed clinical information electronically, the integration can reduce the back-and-forth that occurs when additional documentation is needed before a decision can be made. In September, more than 6,000 providers processed nearly 35,000 electronic prior authorization transactions with Humana, with more than 70% completed without requiring additional information from practice staff.