Pharmacy Reauthorization Workflow

The Challenge

Pharmacy reauthorization for chronic conditions — lipid management, hypertension, diabetes — involved repetitive manual workflows that consumed significant clinical and administrative time. The volume of reauthorizations was growing faster than staffing could keep up.

What We Built

VOPS automated the end-to-end reauthorization workflow, from initial request through clinical review to approval and notification. The system handles the majority of cases autonomously, escalating only complex or exception cases to clinical staff.

The Results

• $25M+ in savings across 5 years
• 39 FTEs equivalent in efficiency gains
• Digitised lipid, hypertension, and diabetes medication workflows
• Reduced turnaround time for routine reauthorizations