The news: Blue Shield of California and Salesforce are partnering to build a new solution to streamline the prior authorization process.
- Announced at HLTH 2024, the solution will be built on Salesforce Health Cloud with testing to begin in early 2025. A limited rollout is set for later in the year.
How it works: While this process currently takes several days, the new solution aims to tackle it within hours.
The tool will search a patient’s electronic health record for relevant clinical information and compile it into a pre-populated form to submit to the insurer. Physicians can then submit prior authorization requests directly from their systems, with patients receiving an answer about approvals during their appointments.
In cases that require a clinical consultation, physicians will receive a message letting them know what information is needed to complete the request.