DrFirst Acquisition Targets Prior Authorization for Specialty Medications

April 18, 2024
Myndshft acquisition aims to expedite access to specialty medications covered by medical benefits, while lightening the administrative load on healthcare providers

To address the issue of prior authorization for specialty medications, healthcare technology company DrFirst has acquired Myndshft Technologies Inc., which offers real-time medical benefits and automated prior authorization software-as-a-service. 

Managing prior authorizations is a significant burden on medical practices because of time-consuming manual processes and lack of integration with electronic health record systems, the company noted. These challenges can lead to avoidable resubmissions and delays, frustrating healthcare providers and patients alike.

DrFirst, whose platform works to enhance e-prescribing workflows and improve medication history, said the acquisition aims to improve the patient experience and expedite access to specialty medications, such as infusions and in-office injectables primarily covered by medical benefits. The technology will also lighten the substantial administrative load on healthcare providers and their staff, the company added.

Founded in 2018, Myndshft streamlines prior authorization and related services for both medical and pharmacy benefits. The platform uses AI, machine learning, and robotic process automation to automate and streamline complex benefits, pricing, and prior authorization processes across various payers and therapeutic classes. The Myndshft platform also supports labs, imaging, and other procedures covered under medical benefits, which are often prerequisites for patients prescribed specialty medications.

"This acquisition is a significant step forward in the industry, which has largely solved these issues for medications covered by pharmacy benefits but has yet to turn its focus to the complex, expensive, and often life-saving drugs covered by a patient's medical benefit," said G. Cameron Deemer, CEO of DrFirst, in a statement. "The category of insurance benefit – pharmacy vs. medical – should not dictate a lower level of transparency or efficiency for prior authorizations. It's unacceptable that the patients who most urgently need these life-saving therapies typically wait the longest to receive them. This acquisition will allow us to expedite patients' access to these crucial treatments."

The Myndshft platform provides eligibility and benefits verification for 95 percent of insured patients across the United States and instantly verifies prior authorization requirements for more than 600 payers and thousands of health plans, DrFirst said. By automatically pre-screening prior authorization submissions for errors and omissions and providing a dashboard for monitoring the status of all prior authorization requests, the platform significantly reduces manual effort by more than 70 percent and cuts claims rework by 90 percent, the company said. 

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