Fort HealthCare automates prior authorizations with 91% success rate
How a high-performing rural community hospital is improving the patient experience while increasing staff engagement
Fort HealthCare is a 49-bed hospital serving Fort Atkinson, Wisconsin and neighboring communities. In 2020, in the midst of the global pandemic, the health system was awarded Modern Healthcare’s Best Places to Work in Healthcare, which recognizes outstanding employers in the healthcare industry nationwide.
As a small community hospital, Fort HealthCare prides itself on its independence and being fully embedded in its community. This is why the health system has invested in tools and resources that empower staff and patients, and embraces innovative technology like intelligent automation to digitally transform healthcare delivery.
“Notable is much more than a vendor. They are a true partner that complements our mission and vision, which is to improve the health and well-being of the communities we serve. Notable was the first organization that listened to our needs – throughout our initial scoping and implementation discussions, their team would come back to us with new solutions and capabilities that could be readily deployed to solve the challenges unique to our community.”
successful authorizations
digital completion Rate
patient satisfaction
weeks to go-live
The challenge
Before partnering with Notable, Fort HealthCare’s ambulatory surgery center was struggling with mounting prior authorizations – 2X the volume of work compared to staff onsite.“We were looking to digitize the entire patient journey, so we knew we needed a long term partner,” said Carl Selvick, PharmD, MBA, FACHE, Former Senior Director, Clinic Operations at Fort HealthCare. "We also had very immediate needs in each of these areas - for example, we had several weeks of prior auths waiting to be submitted which delayed care. In addition, 38% of calls to one of our busiest clinics were going to voicemail, creating a negative feedback loop –patients would end up calling multiple times, resulting in double the work for the same patient.”
Given the importance of processing authorizations to ensure patients can receive timely care and alleviating the heavy burden on staff, Fort HealthCare began their automation journey here.
The solution
By digitizing and automating the registration process with Notable, Fort HealthCare has seen more patients successfully complete their registration, reporting a 74% digital completion rate. This has also resulted in a more than 5% reduction in cancellations. On the backend, Notable works authorization requests for Athena Blue Cross, Humana, United Healthcare, and Dean.
This includes submitting and statusing them within payer portals, or with e-faxing the payers. Notable digital assistants read all documentation via optical character recognition (OCR), even if it originates on paper. Then they automatically append the most appropriate documentation for the payer and write the approval back into the EHR. Today, 91% of prior authorizations submitted through Notable are successful, saving 15 minutes per successful submission. Fort HealthCare went live with automated prior authorizations in just four weeks, and after seeing immediate results, expanded to additional workflows a month later.
