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Physicians, payers vow to partner to reduce prior-authorization hassles

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FierceHealthcare looks at five ways in which physicians and payers are pledging to cooperate to help reduce the difficulties of obtaining  prior authorizations.

They are:


1. “Reduce the number of healthcare professionals subject to prior authorization requirements based on their performance, adherence to evidence-based medical practices or participation in a value-based agreement with the health insurance provider.

2. “Review the services and medications that require prior authorization on a regular basis and eliminate requirements for therapies that no longer warrant them.

3. “Improve communication between health insurance providers, healthcare professionals and patients to minimize delays in care and ensure clear prior authorization requirements, rationale and changes.

4. “Protect the continuity of care for patients on an ongoing active treatment or a stable treatment regimen when there are changes in coverage, insurance providers or prior authorization requirements.

5. “Accelerate industry adoption of national electronic standards for prior authorization and improve transparency of formulary information and coverage restrictions at the point-of-care.”

To read the Fierce article, please hit this link.

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