'Optum Rx’s prior auth tool cuts prescription approvals from 8 hours to 30 seconds'

 Optum Rx — the pharmacy benefit manager for UnitedHealth Group — claims its “PreCheck” prior authorization tool not only cuts prescription approval times but also reduces denials and appeals.

UnitedHealth Group gave an update on the tool in an April 21 earnings call. Optum CEO Patrick Conway, MD, said denials due to missing information dropped by 68% and appeals were down 88%, thanks to PreCheck. He said PreCheck has been “easing interactions for clients, members and providers.”

Dr. Conway reaffirmed that PreCheck has axed prescription approval time from eight hours to fewer than 30 seconds. 

Optum Rx announced an expansion of PreCheck in November, alongside its decision to eliminate reauthorization requirements for 40 medications. In the November release, UnitedHealth Group said, as of this year, the PreCheck platform covers more than 45 medications and is leveraged across 20 health systems.

Insurers have been rolling back prior authorizations since an industrywide pledge last summer, which included UnitedHealthcare. The insurer’s stated goal is to cut prior authorizations by at least 30% by the end of 2026.

Additionally, Optum Rx onboarded more than 800 clients but lowered call center volume by one-quarter through elevated digital and AI-enabled self-service. Member satisfaction surpassed 95%, according to Dr. Conway.

This year, UnitedHealth committed to a $1.5 billion AI spend as it continues to explore use cases, particularly as the tech-enabled services business Optum Insight transitions to an AI-first model.

https://www.beckershospitalreview.com/pharmacy/optum-rxs-prior-auth-tool-cuts-prescription-approvals-from-8-hours-to-30-seconds/