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Develop Health’s PA (Prior Authorization) Policy Search is a crucial feature designed to streamline the process of identifying relevant prior authorization policies for patients. Similar to our Benefit Verification PBM Search, this feature utilizes advanced Optical Character Recognition (OCR) technology and comprehensive data triangulation to determine the most probable prior authorization policy documents based on patient insurance information.

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Process and Technology

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Utilizing Patient Coverage Images

The PA Policy Search begins by scanning patient insurance cards using OCR technology. This process extracts textual data from the card, which is pivotal in identifying the correct prior authorization policies.

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Triangulating Key Data Points

By analyzing various details extracted from the insurance card, such as:
  • Payer Name
  • RxBin
  • RxPCN
  • RxGroup
  • Plan Name
  • State
our system pinpoints the most likely prior authorization policy documents. This multifaceted approach increases the accuracy and reliability of the search.

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Leveraging Formulary Partner Data

We collaborate closely with a formulary partner, utilizing their comprehensive data to validate and refine our search results. This partnership enhances our ability to locate the correct PA policies, ensuring that providers receive the most relevant and up-to-date information.
  • Efficiency: This feature automates a task that would traditionally require significant manual effort, saving valuable time for healthcare providers.
  • Integration: Seamlessly integrating with our platform, the PA Policy Search complements our suite of tools, contributing to a holistic approach to patient coverage analysis and medication management.

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Conclusion

The PA Policy Search feature at Develop Health is a testament to our commitment to leveraging advanced technology to enhance healthcare operations. By accurately identifying PA policies quickly and efficiently, we ensure that patients can access their prescribed treatments without unnecessary delays, and providers can maintain their focus on delivering high-quality care.
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