Medical Economics August 13, 2024
To take advantage of new accelerated prior authorization timelines, providers must step up their internal processes to ensure they can scale while maintaining quality control over prior auth requests and denial appeals
Obtaining prior authorization from a health insurer for a medical test or procedure is a major burden on providers and can negatively impact patient outcomes by causing delays in treatment. In a 2022 survey by the American Medical Association, 89% of responding physicians said prior auths have “a somewhat or significant negative impact” on clinical outcomes, with 33% of physicians reporting that prior authorization has led to a serious adverse event for a patient in their care.
The cumbersome prior auth process also creates severe operational challenges for...
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