The Prior Authorization Framework and Accreditation (PAFA) Program, launched in October 2024, was developed to address the inconsistent practices and antiquated paper claims submission process for prior/special authorization (PA). The Simplify Prior Authorization initiative and others have been advocating for change since 2000. While there is agreement by private payers that change is necessary, only Green Shield is actively engaged. Two provincial payers have implemented substantial improvements in their PA claims process, including electronic prior authorization (ePA).
There is a huge opportunity for private payers to improve the current PA claims process with big benefits for all stakeholders, particularly plan members.
Coming soon: through a series of CE credit webinars and blogs like this one, we will be giving you insights into the PAFA Program that you can share with clients, and how you can help create change at an industry level. Join us to make a difference.
Session #1 – January 23, 2025, 12:00-1:30pm ET
What’s New in Prior Authorization: Making It Better
Register for this webinar here.
When PAFA is successful, you and your clients will see:
- More consistency in the claims process between payers without compromising claims criteria
- Elimination of the existing paper claims process, which means faster times for completion and submission to payers
- Better health outcomes for plan members and their families, less presenteeism, and quicker return to work for those with serious diseases.
Download the PAFA Program Guide and be sure to attend our upcoming webinar series this Fall for more insights!
PAFA is Canada’s only non-profit framework and accreditation program for prior authorization.
You can also book a virtual meeting or webinar for you or your team. Contact Denise Balch, executive director of PAFA, at denisebalch@priorauthframework.ca or call 905 220 4260.
