Becker's Healthcare March 12, 2024
Prior authorization practices and protocols have changed among many major payers in the last year.
Here are 10 things for ASCs to know regarding prior authorization in 2024:
1. CMS updated its interoperability and prior authorization final rule at the beginning of the year. The rule requires payers to implement features including adding information about prior authorizations to their patient access interfaces, creating provider access interfaces to share patient data, claims and prior authorization information, and the requirement for prior authorization decisions to be made within 72 hours.
2. Ninety-seven percent of providers have had delays or denials for necessary patient care due to prior authorization requirements, according to the Medical Group Management Association’s 2023 “Regulatory Burden Report.”
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