US Radiology Specialists (USRS) stands at the forefront of the nation’s radiology landscape, uniting renowned physician-owned practices and cutting-edge diagnostic imaging service providers. The organization is unwavering in its pursuit of clinical excellence, operational efficiency, robust infrastructure, and the latest technological advancements.
As an early adopter of intelligent automation, USRS has improved authorization timelines with greater financial clearance efficiency. However, automating the submission process remained challenging due to non-standardized and dynamic submission criteria. To address this, USRS partnered with AGS Health to implement an EDI 278-based Electronic Prior Authorization Submission feature in the Intelligent Authorization platform.
Challenges
- Time-Consuming Processes: On average, prior authorization submissions took 3-5 minutes for semi-automated payers and 7-10 minutes for manual payers.
- Repetitive Tasks: High-volume payers requiring manual submissions overloaded staff, delaying turnaround times.
- Scaling Bottlenecks: Growing demand and facility expansions amplified operational challenges and staff burnout.
Outcomes
- For one high-volume payer, USRS has saved over 430 hours across 3,465 cases, optimizing processing time and increasing efficiency.
- Achieved a 25% increase in auto-approval rates, streamlining processes and minimizing manual intervention.
- Experienced a 53% increase in processed prior authorization cases, significantly boosting productivity.
- Reduced decision-making time to less than two minutes, greatly enhancing responsiveness.
Time Savings
On average, USRS has saved 7-9 minutes per authorization, enhancing the teams’ prior authorization throughput.
Operational Efficiency
Staff have been redirected to higher-value tasks, increasing productivity despite volume growth and the onboarding of new facilities.
Greater Scalability
The USRS team is now better equipped to scale its operations rapidly without increasing employee headcount.
"The new electronic submission feature is truly amazing... it saves us around 7-9 minutes per exam. This is going to make our team even more efficient and allow us to work further out."
