Healthation has announced the release of an automated real-time pharmacy pre-authorization offering for healthcare payers and pharmacy benefit managers, based on its flagship AcceleHealth benefit management system.
The new product will integrate with a payer’s core medical and pharmacy systems through its web services architecture to auto-adjudicate pre-authorization requests using sophisticated user definable eligibility, benefit, clinical step therapy and workflow rules.
As healthcare grows increasingly digital and new funding models emerge, Scott Kornhauser, Healthation CEO, said that he believes payers will need to extend adjudication capabilities beyond traditional claims processing in order to remain competitive.
For example, he explained, by treating pre-authorization processing the same as claim processing, utilizing the same complex adjudication logic and then integrating workflow into a real-time response, we give payers new capabilities for effecting change at the point of service.
