5 steps to address prior authorization burdens and improve patient care


Originally published in FierceHealthcare

By Robert M. Tennant

The requirement that physicians get prior authorization from insurers before providing a medical service, diagnostic test or medication may be the greatest single bottleneck for the delivery of quality healthcare.

Consider, for example, that the majority of authorizations still happen via manual submission of the request and supporting clinical documentation via fax or phone. Or that rather than getting approval for all that would be needed for a knee replacement—the device, pre-op and post-op visits, crutches, pain medication and physical therapy— in one bundle, in many cases approvals need to be sought for each individual item or service.

No doubt, there are legitimate concerns about ensuring that physicians are recommending necessary and cost-effective treatments for patients.

Robert Tennant is the director of health information technology policy in the Medical Group Management Association’s Washington, D.C., office.

Read the full article at FierceHealthcare.