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Prior authorization will slap more hurdles on orthopedic care, providers say

By Admin | April 12, 2021

Orthopedic providers are pushing back against incoming prior authorization requirements, which they say bring increased administrative burdens and take away from time with patients.

The policy requires providers to get permission before delivering certain medical services, with the goal to minimize costly procedures and act as a check on potentially unnecessary, inappropriate or unsafe medical treatments.

Many insurance plans require prior authorization for orthopedic procedures, imaging and medications, but it is becoming an increasing pain point for providers.

In a recent survey from the American Medical Association, 28 percent of providers reported that the prior authorization process affected care delivery and led to a serious adverse event, with 86 percent indicating that the burden associated with the policy in their practice required an average of nearly two business days per week.

"The amount of time I have to spend getting authorization for simple tests is truly infuriating and results in me being able to spend less time caring for patients," said David Gendelberg, MD, a spine surgeon and member of the North American Spine Society's political engagement committee. "Establishing a prior authorization mechanism would allow me to spend more time doing what I love most, seeing and treating patients."...(More)

For more info please read, Prior authorization will slap more hurdles on orthopedic care, providers say, by Becker's Spine Review

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