Slide Presentation from the AHRQ 2007 Annual Conference

Prior Authorization Testing

• Prior Authorization test with Anthem; "unsolicited model"
  • Prescriber sees drug-specific questions when drug is picked
    • Celebrex, Mobic, Lyrica, Provigil, Viagra, Nexium, Crestor, Vytorin
  • Answer questions, submit and receive response via OnCallData™
    • PLUS parallel fax-based workflow
• All UHMP non-pediatric practices, no training!
• Live 12/10/06
• 30 transactions over 4 weeks
  • 17 prescribers, 13 practices (25/30 by surrogates)
• Mean turnaround time for authorizations: 87 min
  • Highly valued
• Main glitch: 12/30 were "repeats"