Percentage of Medical Services Requiring Prior Authorization
Definition: The number of healthcare services that require prior authorization divided by the total number of healthcare services performed over the same period of time, as a percentage. A healthcare service includes any medical or remedial care or treatment that is meant to prevent, alleviate, or cure any human illness, physical disability, or injury.
Calculation: Number of Services Requiring Pre-Authorization/Total Number of Services Provided
Discussion: Percentage of administrative and payment processes that are approved using prior authorization, allowing for quicker processing and turnaround time.
Leading Indicator: This KPI Definition measures activities which drive a company's high-level results such as revenue.