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Confident Care. Lower Costs.

Prior Authorization Optimization Solutions from MRIoA Deliver Both

Let’s Streamline Your Prior Authorization

Over and underutilization resulting from sub-optimized PA list, or not having the capacity to administer the program, can lead to member frustration as well as higher aggregate service costs. Our reviews efficiently identify areas of savings and improvement and also help you eliminate what is not needed.  Every 6 months, MRIoA’s PA Optimization™ analytics team performs a customized CPT code-level ROI assessment that enables health plans to manage a more targeted prior authorization list.

With MRIoA’s Prior Authorization optimization services, payers can confidently prior authorize only what is needed and reduce the administrative burden of unnecessary prior authorizations. Our clients reduce unnecessary care by $10M over a three year period  per 100K members delivering the “right care, at the right time, in the right place.”

At MRIoA, we believe PA should be more focused and less burdensome. Reducing the services that require PA based on data analytics does just that!

Recurring Analytic Processs

Savings Off of Year Zero Baseline:

Total 3-Year Savings: $10M

PA Optimization Program Analysis Typical Plan 100K Commercial Members

$1.7M Savings Annually

7:1 ROI

Per 100K Lives

Manage Prior Authorizations to Improve Outcomes and Reduce Costs

MRIoA’s PA Optimization platform enables health plans to design and manage a better prior authorization solution, with better quality and reduced  provider abrasion.

UM Market Benchmarks

MRIoA PA Optimization consolidates industry-wide UM research and CPT code-level ROI analytics to help Health Plans create a targeted prior authorization list.

UM Performance Analytics

MRIoA PA Optimization provides up-to-date benchmarking at the procedure level to ensure the best real-time UM program decisions.

Clinical Utilization Review

MRIoA provides flexible clinical review solutions to realize immediate benefit from the PA Optimization recommendations.

PA Optimization Reports Powered by MRIoA Insights

Gain valuable insights as to what to prior authorize and what to eliminate. These reports help to reduce patient, provider and payer burden on what to prior authorize.

Resources

WebinarsResources
04/02/2024

Download the Spring 2024 Regulatory Roundtable Discussion

Case StudiesResources
03/03/2024

How Spark Hire’s Talent Acquisition Suite is Transforming Recruitment for Medical Review Institute of America

Webinars
02/15/2024

Download the MRIoA’s High-Cost Specialty Drug Webinar

High-Cost Specialty DrugsCase Studies
02/09/2024

High-Cost Specialty Drug Review Patient Stories

Read some personal experiences from our High-Cost Specialty Drug Review program.

Drive Cost Savings and Elevate Patient Care

Experience valuable data insights, cost savings, and faster decision-making with our innovative technology and patient-centered approach.

A ClearPath to Clinically Relevant Simplicity.

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