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Surescripts
Approved before patients know it
Prior authorization for medication is intended to protect patient safety and support cost-effective care. But cumbersome manual processes undercut these goals, triggering delays and frustration across healthcare.
Touchless Prior Authorization matches clinical data with determination criteria to help reach a clinically appropriate decision as quickly as possible. It automatically retrieves required information from the patient’s electronic health record and sends it to the pharmacy benefit manager (PBM).
When prior authorization requirements are met, the request can be approved without human intervention. That means patients can get started on appropriate medications quickly, with less work for everyone.
30 seconds–3 minutes
average approval time during pilot for in-scope medications
88% fewer
appeals during pilot for in-scope medications
68% fewer
denials due to lack of information during pilot for in-scope medications1
What can Touchless Prior Authorization do for you?
Choose your organization type to see how Touchless Prior Authorization can help you speed up prior authorization for medications.
Give providers a dramatically more efficient prior authorization experience
Vanquish a major source of frustration for your customers with prior authorization automation. Touchless Prior Authorization draws on data that’s already in your EHR and automatically sends it to the PBM for approval—with little or no provider action required.
Keep providers in workflow
Make prior authorization a seamless—even effortless—part of the e-prescribing experience, delivering more value within your platform.
Improve patient experience
Reduce delays and set the stage for better medication adherence by helping patients get approved medications right away.
Gain speed with built-in intelligence
Touchless Prior Authorization doesn’t rely on manual work behind the scenes. It genuinely automates the process of preparing and delivering the information payers require.
How it works for EHR vendors
The prescriber or EHR initiates prior authorization for a qualifying prescription.
Then, if Touchless Prior Authorization is available for the patient and medication, the process begins automatically.
Surescripts retrieves clinical data from your EHR to complete the question set.
Partnerships with PBMs make it possible to determine the precise clinical values required for prior authorization.
If all criteria are met, the payer sends an automated approval.
If the request can’t be instantly approved, the prescriber is prompted to complete the request through your EHR.
The prescriber receives the approval and the patient can start their medication promptly.
Your EHR receives a message confirming that the prescription has been authorized with little or no work for staff.
Minimize treatment delays & free up time for patient care
Vanquish a major source of frustration with prior authorization automation. Touchless Prior Authorization draws on existing clinical documentation and automatically sends payers the data they need for approval—with no provider action required.
Get prior authorization decisions faster
When prior authorization criteria are met, approvals can be delivered in seconds or minutes. When more information is needed, providers are prompted to complete additional steps.
Improve time to therapy
About 40% of prescriptions delayed by the manual prior authorization process are abandoned.2 Support greater adherence by helping patients get approved medications right away.
Gain speed with built-in intelligence
Touchless Prior Authorization doesn’t rely on manual work behind the scenes. It genuinely automates the process of preparing and delivering the information payers require.
How it works for health systems
A prescriber writes an e-prescription that may qualify for automated approval.
If Touchless Prior Authorization is available for the medication, Surescripts empowers your EHR to start the process.
Surescripts retrieves clinical data from the EHR to complete the question set.
Partnerships with PBMs, health plans and your EHR make it possible to collect the exact information required.
If all criteria are met, the payer sends an automated approval.
If the request can’t be instantly approved, the prescriber is prompted to complete the request through your EHR.
The prescriber receives the approval and the patient can start their medication promptly.
Your EHR receives a message confirming that the prescription has been authorized with little or no work for staff.
Reduce operational costs without compromising clinical rigor
Deliver clinically appropriate prior authorization decisions faster. Touchless Prior Authorization brings you the patient data and automation needed to reach approval with minimal manual intervention.
Get the precise clinical values you need
Touchless Prior Authorization gathers required clinical information straight from the patient’s EHR, reducing the risk of receiving incorrect or incomplete data.
Make decisions at the time of prescribing
Reduce the need for follow-up calls and create a vastly more efficient prior authorization experience for everyone involved.
Pave the way for medication adherence
About 40% of prescriptions delayed by the manual prior authorization process are abandoned.2 Support greater adherence by helping patients get appropriate medications right away.
Gain efficiency with built-in intelligence
Touchless Prior Authorization doesn’t rely on manual work behind the scenes. It genuinely automates the process of preparing and delivering the information you need.
How it works for PBMs
Select medications and question sets that are a good fit for Touchless Prior Authorization.
We’ll align on automated question sets that can be answered with clinical values retrieved from the EHR.
Touchless Prior Authorization is initiated within the e-prescribing workflow.
If Touchless Prior Authorization is available for this medication, Surescripts retrieves the clinical data you need.
You receive and analyze the completed question set.
If the prior authorization criteria are met, you can send an automated approval.
The provider receives an approval message in their EHR.
With little or no manual intervention, the prescription is authorized and your member can start their medication.
Find out more about Touchless Prior Authorization
With Touchless Prior Authorization, are all prior authorization decisions automated?
No. Only approvals are returned through Touchless Prior Authorization. Denials are never made automatically. If the request cannot be approved based on the clinical information submitted, the provider will be prompted to complete a prior authorization request. This can happen via Electronic Prior Authorization or another method, depending on implementation.
How much can Touchless Prior Authorization speed up prior authorization for medication?
Since approvals can be delivered almost instantly, time savings can be significant. For pilot participants, prior authorizations for in-scope medications dropped from an average of 15–20 minutes to an average of 0.5–3 minutes.3
What other results are being seen with Touchless Prior Authorization?
In addition to faster approval times, pilot participants have seen significant reductions in appeals, denials due to lack of information, and abandoned prior authorization requests, among other benefits. Read the case study “Leveraging Innovative Technology to Streamline Medication Prior Authorizations” for more details.
How can we be sure that the clinical data used for Touchless Prior Authorization is accurate?
Touchless Prior Authorization collects actual clinical values from the patient's EHR and transmits them to the PBM alongside metadata verifying the source of the information, creating an audit trail that can be reviewed by the PBM at any point. Clinical information is always transmitted directly, never inferred from other sources.
Keep pace with healthcare innovation
- KLAS Research K2 Collaborative, "Case Study: Leveraging Innovative Technology to Streamline Medication Prior Authorizations," September 2024, p. 3.
- Gulzar Virk and Tony Schueth, "Electronic Prior Authorization: Leveraging the Latest Technologies to Improve Care Delivery and Determine Optimal Benefit Coverage," 2016.
- KLAS Research K2 Collaborative, "Case Study: Leveraging Innovative Technology to Streamline Medication Prior Authorizations,” p. 3.
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