Cardiology Health System Case Study

Digitalizing Prior Authorization Improves Patient Engagement for Mid-Atlantic Cardiology Network

10

Hospitals

32,000

Associates

300+

Care locations

About

Nestled in the Mid-Atlantic corridor, this leading health system, with its 10 hospitals and over 300 care locations, is dedicated to providing top-tier healthcare services across Maryland, Virginia, and Washington, D.C. Upholding the SPIRIT values (Service, Patient First, Integrity, Respect, Innovation, and Teamwork), it employs more than 32,000 associates focused on making healthcare accessible while ensuring patients feel valued and confident in their care

Challenges

Specializing in vital cardiovascular services such as Open-Heart Surgery, Echocardiograms, and Cardiac Catheterizations, the network operates around the clock. However, inconsistent coverage from a previous vendor led to delayed patient procedure authorizations, causing reschedules and denied services due to untimely authorizations, despite the non-stop delivery of medical services.

Solution

Digital Empowerment in Patient Engagement

To address this challenge, Ascent Health Solutions introduced their Patient Engagement services through the innovative ARMS Ai service platform. Leveraging a powerful combination of automation, Ai/ML models, and rules-based algorithms, Ascent enabled provider to increase days out for prior authorization time to an industry leading 30 days.

Smart Automation

The digital process, through payer integration, replaced over 10,200 annual manual tasks with robotic process automation and intelligent analytics. The automation seamlessly integrated with the scheduling system, identifying procedures requiring prior authorization and automating follow-ups for open authorizations.

Transparency

The transformation not only streamlined operations but also introduced unparalleled transparency, allowing for real-time tracking of the prior authorization process via standardized dashboards.

24×7 Coverage without Human Dependency

One of the most significant hurdles, providing consistent coverage during third shifts and weekends, was overcome through ARMS Ai’s seamless integration with Hospital and Ambulatory Health Information Technologies, offering uninterrupted support for the cardiology program.

Medical Record Automation

ARMS Ai’s automation capabilities extended to pulling thousands of medical records, preparing essential documentation for the prior authorization process efficiently.

Outcomes

Leveraging Ascent Health Solutions’ digital expertise, the ARMS Ai platform delivered unprecedented improvements in financial performance and patient care efficiency across the cardiology network.

98%

Quality score

200%

improvement
In average days out

100% Elimination of Delayed Authorizations

Timely filing issues, a significant operational challenge, were entirely eradicated, ensuring no delays in processing patient procedures..

Scalability for Procedures Authorizations

With ARMS Ai, the health system now successfully authorizes 80,000 procedures each year, showcasing the platform’s scalability and impact.

24/7 Coverage

One of the system’s most critical needs, continuous coverage, was fulfilled with ARMS Ai, providing reliable support across all shifts and weekends.

The ARMS Ai platform’s deployment within this leading cardiology health system has marked a significant milestone in the use of digital strategies to enhance patient engagement and streamline the revenue cycle. By addressing and overcoming the operational challenges of prior authorizations, Ascent Health Solutions has not only improved the cardiology health system’s financial health but also ensured that patients facing challenges receive timely care.

“Ascent’s ARMS Ai platform and their team’s expertise have been pivotal in transforming our approach to patient care and operational efficiency.”

VP of Cardiovascular Services

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