PRIA Healthcare is a patient access and reimbursement solutions company specializing in patient-based appeals of denied care.
PRIA partners with medical device companies, healthcare providers, and healthcare organizations to ensure that patients are afforded appropriate coverage for the care that they are prescribed.
Guided by the PRIA Patient Access Process, their team of Patient Access Specialists has the experience and expertise to ensure that patient’s rights to prescribed care will always be exercised to the fullest extent.
A Need to Streamline Prior Authorization Requests
PRIA acts as a liaison between medical device companies and payers to help obtain prior authorizations for procedures.
Late in 2018, PRIA recognized it needed an efficient, scalable way to manage their medical device customer requests for prior authorizations. Each medical device customer had a different process for interacting with payers. PRIA sought a way to optimize tracking which cases had been submitted by which provider and medical device client.
PRIA Selects a Healthcare-Focused Salesforce Partner
PRIA selected J2 as their Salesforce Health Cloud implementation partner to optimize their existing Health Cloud org and convert it from Classic to Lightning.
J2 built a Customer Community (based on Salesforce’s Experience Cloud) for each of PRIA’s medical device customers. Now, practitioners can submit cases directly to PRIA to obtain prior authorization. Each customer has their own workflows set up within PRIA’s org.
Providers can self-register on Customer Communities with the help of a custom Lightning Component built by J2. Salesforce’s Lightning Component framework facilitates the development of web apps for mobile and desktop devices.
J2 built a process to inform medical device clients that their prior auth request has been denied. Access was created for the device manufacturers for reporting. Visibility to reports is controlled for HIPAA compliance and territory level access reasons.
The configuration and setup of Health Cloud and Experience Cloud have improved PRIA’s operations, making them simpler and more seamless.
J2’s team migrated Visualforce pages to Lightning Components for modularization and continued customization. PRIA’s team is now able to take a “clicks not code” approach.
In the first quarter after implementation, PRIA enrolled 636 new contacts vs. 60 the prior year, a more than a tenfold increase.