As front-end RCM tasks continue to create administrative burden, patient delays, and operational strain, leading health systems are looking for smarter ways to scale prior authorizations.
For Prisma Health and Advocate Health, success starts with more than automation alone. It requires strong processes, thoughtful rollout, and workflows that help teams focus where human expertise is needed most.
With Waystar, both organizations are modernizing prior authorization by reducing manual touchpoints, moving routine volume out of work queues, and creating more efficient paths to approval.
The way forward for Prisma Health + Advocate Health
At Prisma Health, automation begins when an appointment is scheduled in their EHR, Epic®. From there, the authorization request moves through Waystar and payer connections — with approvals returned directly into Epic® when no additional clinical documentation is required.
For those touchless cases, staff no longer have to manually enter information into payer portals or make phone calls to move the authorization forward.
Advocate Health emphasized the importance of preparing workflows before automating them. Standardized processes help ensure automation supports the team, instead of accelerating complexity.
Build momentum with measurable wins
Rather than rolling automation out everywhere at once, Advocate Health took a phased approach — starting in smaller markets to build confidence, demonstrate value, and create momentum before expanding further.
That strategy helped teams see how automation could remove volume from their queues and support day-to-day work.
Prisma Health also brought frontline team members into the workflow design process, helping shape how clinical documentation requests are surfaced, prioritized, and worked in Epic®.
Support scale + optimize growth
Both organizations are using automation to support growth — not simply reduce headcount.
As authorization volume increases, Waystar helps reduce repetitive manual work while giving teams clearer visibility into the cases that need attention. When additional documentation is required, staff can quickly identify those requests and take action.
By combining automation, interoperability, and workflow intelligence, Prisma Health and Advocate Health are building a smarter, more scalable approach to prior authorization.
See how Waystar helps healthcare organizations simplify prior authorization and accelerate approvals.
