The Digital Clinical Assistant is your solution to the prior authorization process. The Digital Clinical Assistant leverages innovative AI technology and a digital workforce to automate the burdensome process within Athenahealth EHR- eliminating the need to learn new tech or add to existing workflows. As a result, the DCA can improve the time to approval by up to 50%, increasing the number of approvals you can process daily. In addition, the DCA can reduce the cost of prior authorization by up to 60% and alleviate the administrative burden on your staff.

Digital Blue is a healthcare consulting and solutions company focused on improving lives through optimized business performance. Our services and solutions empower leaders across the healthcare ecosystem to eliminate inefficiencies, increase productivity and improve patient satisfaction. Client benefits include; increased revenue, reduced operational cost and administrative burden, and improved quality of care. 

HealthNautica’s eORders™, software is a comprehensive, easy-to-use, cloud solution for managing the entire perioperative process and surgical scheduling without changing your scheduling system. It begins with the physician’s office filling out an online surgery scheduling or procedure request.

Gone are the days of illegible, incomplete, inaccurate faxes sent back and forth between the physician’s office and the facility’s scheduling department. The cumbersome and error prone faxing process is replaced by an electronic form that is configured to each facility’s exact specifications and reacts to the user’s input thereby assisting the physician’s office in getting it right the first time.

All orders are legible, complete, screened for CMS Medical Necessity, incorporate SCIP, VTE, SSI and ACS NSQIP measures, verified for insurance eligibility, pre-certified and satisfy edits by CMS, commercial payers and the facility. Our solution ensures efficient surgery center scheduling and block time management while streamlining processes such as prior authorization.

Healthcare Software Developer

Prior Auth Process As-Is

Prescriber opens the EMR and prescribes the prescription.

The pharmacy will notify the prescriber that a prior auth is needed

Prescriber will submit an electronic request for prior authorization through ePA or insurance portals

Prescribers and their staff input patient demographic information and history and answer clinical questions as they come in. 

The staff is constantly checking for status updates

Duplicate requests come in, typically at night and over the weekend. If the PA request isn't completed quickly enough, these must be filtered out manually.

Backlogged workbaskets and data-entry errors cause care gaps and delays in treatment.

Increased administrative burden is the number one cause in provider burnout and a significant cause for loss in revenue

DCA Optimized Prior Auth Process

The Clinician Opens the EMR and prescribes the medication

DCA monitors the EMR and other systems for PA work and kicks off the automated process

DCA auto-triages PAs and removes ALL duplicate requests as they come in

DCA auto-fills forms via APIs and submits the requests for medications it has been configured for based on your practices' volumes

DCA creates a work queue for any encountered exceptions

nurses work only the PA requests or clinical questions that the DCA is not configured for, saving time for high-value work

Based on payer rules, the DCA posts status updates/tasks to EMR and auto-updates status

60% reduction in manual effort

50% improvement in time to approval

100% elimination of duplicate requests

See more patients, improve employee satisfaction/retention, and get home on time!

Provides agnostic interoperability that integrates a solution outside the competancy of the EHR and facilitates a companion to the EHR

Pricing and customer support are key