Case Study: Eliminating Prior Authorization Backlogs to Improve Patient Access and Operational Efficiency

NYX Health helped a Georgia health system reduce outstanding referrals and streamline authorization workflows.

Background

A Georgia-based health system partnered with NYX Health to improve prior authorization efficiency, reduce administrative burden, and accelerate referral resolution across a high-volume payer environment.

Over a six-month period, NYX Health managed and reviewed thousands of referrals while maintaining fast turnaround times and low denial rates.

The Challenge

The health system faced increasing prior authorization complexity due to varying payer requirements, growing referral volume, and operational strain on internal teams.

The organization needed a scalable solution that could quickly review referrals, determine authorization requirements, and resolve accounts efficiently without delaying patient care.

The NYX Health Solution

NYX Health implemented a centralized prior authorization review and resolution workflow designed to improve efficiency and reduce unnecessary payer submissions.

NYX Health handled:

• Prior authorization requirement review
• Payer workflow determination
• Authorization submission and follow-up
• Referral resolution management
• Identification of accounts not requiring authorization

Results

Over the six-month engagement, NYX Health delivered measurable performance improvements:

• 98% of Prior Authorization Backlog Resolved with a 21-Hour Average Turnaround Time
• 7,656 Referrals Processed with Only a 1.9% Denial Rate
• From Growing Backlog to 98% Resolution Rate
• Resolving Prior Authorization Backlogs Without Sacrificing Accuracy

The Impact

NYX Health helped the health system significantly reduce a growing prior authorization backlog by resolving 98% of outstanding referrals while maintaining a low denial rate and fast turnaround times. By improving workflow efficiency and reducing delays, the organization was able to support patient scheduling more effectively and relieve pressure on internal staff.

Learn more about our Prior Authorization Services.