5 ways healthcare hopes to improve prior authorization

Prior authorization is often listed as one of the biggest hassles for many healthcare facilities, with plenty of calls for collaboration between major associations to streamline the onerous process. Those efforts have now led to a consensus statement from six groups on their shared goals for preapproving patients’ medical treatments.

The American Hospital Association, America’s Health Insurance Plans, American Medical Association, American Pharmacists Association (APhA), Blue Cross Blue Shield Association and Medical Group Management Association recommended focusing on five areas of improvement:

  1. Selective application of prior authorization
  2. Program review and volume adjustment
  3. Transparency and communication
  4. Continuity of patient care
  5. Automation to improve transparency and efficiency

“Meeting health plan proprietary authorization requirements consume significant time for both clinical and administrative personnel, diverting staff away from providing direct patient care, and costing practices countless dollars to administer,” Anders Gilberg, MGMA’s senior vice president of government affairs, said in a statement. “Most importantly, the prior authorization process can result in delayed or denied patient care.”

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