Tennessee Oncology, one of the nation’s largest, community-based cancer care specialists and founding practice partner of OneOncology.
With increasingly complex requirements for buy-and-bill drugs, Tennessee Oncology was finding it “almost impossible” to keep up to date with prior authorizations, even with 12 employees dedicated to the task. Without an efficient way to measure and optimize the follow up associated with prior authorization submissions, Tennessee Oncology was facing preventable operational expenses both in terms of productivity and missed opportunities.
Tennessee Oncology partnered with SamaCare, integrating their EMR with SamaCare’s centralized platform for submitting, tracking, and managing prior authorizations. “SamaCare is like our authorizations team’s own personal assistant.” — Stacey Poole, Director of Patient Accounting, Tennessee Oncology.
In the first 5 months of working with SamaCare, Tennessee Oncology saw the immediate effects of a more streamlined prior authorization process: 62% faster prior authorization resolution, 33% more prior authorizations getting approved prior to the intended date of service, and an estimated total 468 staff hours saved. They were able to achieve these operational improvements by finally filling the gap in tracking the overall productivity and performance of their prior authorizations team. A better process for prior authorizations has also resulted in fewer missed opportunities leading to 20% fewer PA denials and fewer downstream claim denials.
Tennessee Oncology, one of the nation’s largest, community-based cancer care specialists, is home to a leading clinical trial network. They provide on-site chemotherapy treatment at 30 locations, with 12 full time prior authorization specialists. Tennessee Oncology strives to provide access to high-quality cancer care and the expertise of clinical research to all patients within their communities. Prior authorizations can severely inhibit this goal. Oncology is a challenging specialty for prior authorization because of the experimental nature of medications and regimes. Prior authorizations for buy-and-bill drugs have become increasingly complex, with varied workflows across payers and ever-changing requirements.
Tennessee Oncology’s prior authorization team dedicated significant time to the process: navigating complex requirements across payers, keeping up with new policies, and tracking prior authorizations to ensure timely delivery of care. The team found it difficult to keep up with demand and associated follow up, leading to increased payer resolution times and missed opportunities. This was especially impactful given the size of the practice - even a small percentage of claim denials can add up to hundreds of thousands of dollars per year. Tennessee Oncology needed a way to house and surface all communication for prior authorizations in one place, allowing for greater efficiency in measuring team productivity and performance.
Tennessee Oncology partnered with SamaCare to streamline prior authorization management through one unified portal for submitting, tracking and troubleshooting prior authorizations; leveraging features like:
The ability to measure team productivity is a “game-changer.”
“In 20+ years as a Revenue Cycle Manager, I’ve never had a good way to monitor team performance or quantify success. SamaCare gave us that tool, and as a result, we’ve improved our productivity AND decreased the likelihood of expensive missed prior auths.”
— Tracy Valrie, Revenue Cycle Manager, Tennessee Oncology
Visibility across all of their prior authorizations and tools to streamline prior authorization workflows.
One unified portal to submit, manage, and track prior authorizations with direct EMR integration.
Visibility across all of their prior authorizations and tools to streamline prior authorization workflows.
One unified portal to submit, manage, and track prior authorizations with direct EMR integration.
Tennessee Oncology has seen average time to resolution on prior authorizations improve by 62%. The team has seen better prior authorization management lead to an increase in prior authorizations approved before the intended date of service (+33%), higher prior authorization approval rates, and an estimated total of 468 staff hours saved. They have also seen a 20% reduction in PA denials over that time. These improvements have helped reduce claim denials downstream, saving the practice significant revenue losses as a result of denied reimbursements.
“SamaCare is definitely the best product that we’ve found for drug authorizations, and we’ve looked at a lot.”
Get in touch today and we’ll walk you through how SamaCare can help your practice streamline prior authorizations.
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