By David Shelton – A staggering 90% of physicians say manual prior authorizations are a concern, according to the 2019 CAQH Index. Further magnifying the current situation are payers’ intentions to increase prior authorization requirements for even more services in the near future.
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By Krithika Srivats – Providers view prior authorization as a manual, burdensome, and laborious process, mostly because of process missteps such as lack of clinical data integration, inconsistency in data exchange standards, and differing policies among payers.
Physicians across the country and across specialties are urging CMS to reduce the harms and burdens of prior authorization by incorporating Consensus Principles into its policies and encouraging other payers to do so as well.
A coalition of eight national medical specialties pledged support for the bipartisan Improving Seniors’ Timely Access to Care Act of 2019 (H.R. 3107), legislation that would protect patients from unreasonable Medicare Advantage plan requirements that…
By Sita Kapoor – More than nine in 10 physicians say that pre-authorization programs have a negative impact on patient outcomes, according to a recent survey by the American Medical Association.
As the call for prior authorization reform continues to make headlines and drive high-level conversations among healthcare industry stakeholders, the discussion surrounding the topic will continue at WEDI 2017- Driving Solutions in a Changing Healthcare Environment.
By Deanne Kasim – With the increase in specialty drugs, innovative diagnostic testing, and precision medicine, it is expected that the use of the Prior Authorization will only increase with health insurance companies. Of course I have heard from many re: the (theoretical) fact that as the use of value-based provider reimbursement matures, there will be less and less need for a PA process.
By Robert Rowley MD – One of the most frustrating elements of the current healthcare environment is the administrative burden of prior authorizations for medications and procedures. It is a frustration for providers, for patients, and for payers. Is there any way to solve this dilemma?