DrFirst buys prior authorization automation platform Myndshft

Steven Loeb · April 19, 2024 · Short URL: https://vator.tv/n/5863

This will allow DrFirst to accelerate its growth in the specialty medication space

Managing prior authorization (PA) is a significant burden on medical practices because of time-consuming manual processes and lack of integration with electronic health record (EHR) systems. These challenges lead to avoidable resubmissions and delays, frustrating both healthcare providers and patients.

Myndshft Technologies is a unified platform that automates benefits, pricing, and PA for both medical and pharmacy benefits through the use of AI, machine learning, and robotic process automation.

That technology is what made them attractive to DrFirst, a technology platform that's embedded in roughly 300 different EHRs, solving problems around workflows, interoperability and patient compliance, which announced its acquisition of Myndshft on Thursday.

No financial terms of the deal were disclosed, but it was revealed that Myndshft will remain in operation as part of the DrFirst family and that 28 employees from Myndshft at joining the company, with their executive team taking on leadership roles within DrFirst.

By integrating Myndshft, DrFirst will be able to accelerate its growth in the specialty medication space, add new expertise and technology in AI and automation, and allow it to solve transparency and prior authorization issues.

"The acquisition enables us to help providers and patients improve access, affordability, and adherence for all medications, regardless of whether they are covered under a pharmacy or medical benefit," G. Cameron Deemer, CEO of DrFirst, told VatorNews.

"Myndshft's payer- and staff-workflow expertise is a game changer that fast-tracks our growth in current and adjacent markets, including specialty hubs, infusion centers, specialty pharmacies and hubs, and specialists and their clinical teams."

Founded in 2018, the Myndshft platform supports labs, imaging, and other procedures covered under medical benefits, which are often prerequisites for patients prescribed specialty medications.

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

DrFirst, meanwhile, helps connect physicians, pharmacies, and hospitals so they can work together and collaborate on the patient in the middle.

For example, when a patient enters a hospital, they will be asked what medications they take, but people have incomplete memory, or they may not be responsive. So, the hospital is going to pull a med history report from an industry standard source. However, the report is going to be incomplete, and the hospital may not even be able to import it. DrFirst takes that report and cleans it up, while also bringing other sources into it, such as pharmacies that patients may have been visiting, as well as information from payers.

As a result, DrFirst can take what's about a 70% complete patient record and make it close to 95% complete, saving tremendous time and hassle, and also avoiding adverse drug events when you're admitted to the hospital.

The DrFirst solution is used by more than 350,000 prescribers, 71,000 pharmacies, 270 EHRs and health information systems, and over 2,000 hospitals in the U.S. and Canada.

"Myndshft was a good fit for us because of their innovative technology and strong team. We also share a similar mission, philosophy, and pioneering spirit. As we’ve continued expanding our abilities in intelligent medication management, we identified a massive unsolved problem that exists with medications covered under medical benefits," Deemer explained.

"The Myndshft technology and expertise, combined with our scale and focus on clinical workflows, will improve the patient experience and lighten the substantial administrative load on healthcare providers and their staff."

The two entities are already starting on several integrations, and they will be working directly with their customers to explore their needs, workflows, and desired integrations to support their initiatives, said Deemer.

In addition, this acquisition makes DrFirst the first medication management vendor that can support providers and patients for drugs covered by their medical benefit or pharmacy benefit, he said.

"This can immediately ease the substantial administrative burden on healthcare providers and their staff, improve the patient experience, and speed time to therapy for patients who need specialty medications."

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