Prior Authorization for Providers
Premier’s Stanson Health artificial intelligence (AI)-powered clinical decision support and automation help eliminate the administrative burden of prior authorization by embedding intelligence directly into the electronic health record (EHR). Orders are designed to be guided, documented and submitted in real time — without portals, phone calls or workflow disruption.
Prior authorization costs the U.S. healthcare system $31 billion each year, with one in three requests delaying care and providers spending an average of 45 minutes per submission navigating manual processes. By embedding intelligence directly into the clinical workflow at the point of order, this approach helps ensure the right information reaches the payer instantly — reducing delays, minimizing denials, lowering costs and eliminating the traditional tradeoff between utilization control and provider burden.
Two Solutions, One Goal: Prior Authorization
ImagingGuide+
ImagingGuide+ is a real-time clinical decision support solution that is designed to guide imaging orders at the point of care, delivering evidence-based recommendations before prior authorization begins. By automatically evaluating orders against accredited criteria, prompting for missing information and suggesting more appropriate alternatives within the workflow, it helps reduce denials, improve ordering quality and prevent unnecessary utilization at the source.
EMPA Integration and AuthAssist
AuthAssist and Electronic Medical Prior Authorization (EMPA) Integration is designed to transform prior authorization into a fully automated, end-to-end workflow by pairing turnkey EMPA implementation with intelligent payer routing. Clinical documentation is automatically captured, formatted and submitted to any DaVinci-compliant payer, with real-time status updates returned directly into the workflow. This approach reduces manual work by over 80 percent, accelerates approvals from days to minutes and eliminates the need for portals or custom integrations — helping organizations scale efficiently while staying prepared for evolving CMS interoperability requirements.
Why ImagingGuide+?
Improve Inpatient Reimbursement
Improve reimbursement based on diagnosis-related groups.
Improve Outpatient Imaging
Reduce care requests likely to be denied by health plans and benefits managers.
Meets AUC/ PAMA Compliance
Embedded CDS tool designed to comply with Centers for Medicare and Medicaid Services (CMS) mandate.
ImagingGuide+ Benefits
• Adjusts CDS guidance based on analytics to help target the most impactful ordering situations.
• Uses NLP to read data and help suppress nuisance alerts.
• Understands provider ordering patterns via ML to display the highest impact CDS only, and more.
• Reassessment of rules after the point-of-order entry and alerting to help understand what providers document after interacting with Premier's Stanson Health app.
• Designed to provide increasingly meaningful CDS from what is learned on re-evaluation.
Provider-centric, peer-comparison feedback in decision support designed to enable providers to understand and compare their performance.
Offers a growing CDS library of imaging UM alerts for all imaging areas and settings (AMB, IP, ED), not just the Priority Clinical Areas. Supports savings and quality improvements identified by literature and real-world insights in provider and payer organizations.
Designed to enable governance by displaying trending utilization, outlier and savings metrics.
ImagingGuide+ is foundational tech that can be used in combination with Premier's AuthAssist and ImagingAssure solutions, which are technologies supporting electronic submission and expedited PA reviews.
AuthAssist: Assisting Providers in Real-Time Authorization Approval
Reduce Care Delays
Providers, payers and patients can immediately experience the benefit of an automated, real-time prior authorization approval process.
Automate Clinical Reviews
Eligibility and clinical necessity are both assessed based on payer guidelines, enabling a real-time decision to be delivered at the point of care versus reviews downstream that take time.
Save Time & Expense
This improves the overall experience for everyone, including the patient, and saves both providers and payers the time and expense spent managing the manual prior authorization process.
How AuthAssist Can Help
Improve provider engagement with tech that providers can easily understand and prefer over the traditional prior authorization process.
Designed to verify medical necessity in less than a minute and avoid peer-to-peer reviews on approvable cases.
Enable near-immediate decision making with requests that can be approved in less than one day.
Reduce the number of cases that require human review with provider engagements while lowering downstream review costs.
ImagingGuide+ can help with imaging CDS in the EHR to guide provider decision making to help reduce clinically inappropriate and potentially harmful orders. It also works collaboratively with our payer tools such as ImagingAssure.
Why Choose Premier?
We bring proven expertise in healthcare solutions, specializing in improving efficiency and delivering better outcomes for payers, providers and patients. With our innovative prior authorization tools, including ImagingAssure and AuthAssist, we offer an integrated platform that combines automated prior authorization, point-of-order clinical decision support and fully managed radiology benefit management into one seamless solution.
By streamlining the entire prior authorization process — capturing and submitting documentation automatically, delivering real-time guidance and providing board-certified radiologist review — our solutions reduce provider burden, minimize unnecessary utilization and accelerate approvals without the delays and friction of traditional approaches.
Now is the time to optimize your prior authorization process for greater efficiency and better patient outcomes.
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