For patients prescribed specialty medications, every day waiting for a prior authorization (PA) is a delay in critical treatment. In the specialty pharma space, where therapies often target serious or complex conditions, the prior authorization process plays an even more pivotal role.
At careviso, we understand how essential it is to reduce time to therapy. Knowing what to expect and where delays tend to occur can help HUBs, manufacturers, and providers create a more efficient path to access for patients.
Timelines for specialty prior authorizations vary depending on payor, therapy class, and the level of documentation required:
Specialty drugs are high-cost, high-touch therapies with complex administration, distribution, and monitoring requirements. Because of these factors, the PA process is more detailed—often requiring:
These steps require coordination between providers, payors, specialty pharmacies, and HUB services—many of which still rely on faxes, phone calls, and manual follow-ups.
Delays in specialty PA don’t just impact time-to-therapy—they lead to increased abandonment, decreased adherence, and worsening patient outcomes. Research published in Managed Healthcare Executive indicates that while prior authorization requirements apply to about 7% of all prescription claims, more than a third of those prescriptions (37%) are ultimately not filled.
READ MORE: careviso Releases Comprehensive 2024 Audit Uncovering Ongoing Administrative Burden of Prior Authorizations in Diagnostic Testing
How careviso Helps
Our solution, seeQer, can identify if a prior authorization is required for each patient case. Our platform enables:
The result? A more transparent and efficient process that shortens the path from prescription to therapy.
In specialty pharmaceuticals, prior authorization plays a critical role in how quickly patients can start essential therapies. careviso is committed to supporting this process by providing the transparency and efficiency needed to reduce delays and improve access to care.
Schedule a seeQer demonstration of benefits verifications, cost assessments, and other essential tasks in the platform. Learn how seeQer can help your organization reduce administrative burden, transform cumbersome processes, and provide transparency that empowers patients in a complex and ever-changing industry.