Discover and read the best of Twitter Threads about #FixPriorAuth
Most recents (6)
🎇#FixPriorAuth
🧵”The approval process health insurers impose on medical services or drugs is generating a toll that exceeds the purported benefits, according to a physician survey released today by @AmerMedicalAssn and shared in a letter to federal health officials.”
🧵”The approval process health insurers impose on medical services or drugs is generating a toll that exceeds the purported benefits, according to a physician survey released today by @AmerMedicalAssn and shared in a letter to federal health officials.”
2/ For an infographic of the survey results, please see👇
ama-assn.org/system/files/p…
For more from the @AmerMedicalAssn press release, please read on. #OurAMA
ama-assn.org/system/files/p…
For more from the @AmerMedicalAssn press release, please read on. #OurAMA
3/ “While health insurers claim prior authorization requirements are used for cost and quality control, a vast majority of physicians say authorization controls lead to unnecessary waste and avoidable patient harm.”
#FixPriorAuth
#FixPriorAuth
Part 2 of ACP-Medicine Forward series on solutions to #FixPriorAuth happening now w/ amazing lineup! @gabrieldane, co-founder w/ @EricTopol of @MedicineForward, kicks off the mtg w/ comments about urgency of #MedTwitter #advocacy & activism to protect dr-patient relationship.
Dr. @ShikhaJainMD is orienting audience to the amt of time #MedTwitter spends doing prior auth & peer-to-peer calls, in many cases w/ insurance company "peers" w/ no training in the specialty. Some could not even pronounce the tumor type or drug name. #DenialOfCare #FixPriorAuth
Dr. @ShikhaJainMD says that she cares for a patient with #cancer whose insurance company only allow 4 CT scans LIFETIME for their #cancer, which prevents her from assessing how well the treatment is working. This is absurd & MUST be fixed. #DenialOfCare #FixPriorAuth #MedTwitter
Today is National Physician Suicide Awareness day. #NPSADay
A couple of issues drive problems with physician mental well-being:
- Job-associated burnout
- Stigma and harm associated with seeking help (having to report this condition on your license, and to your hospital)
A couple of issues drive problems with physician mental well-being:
- Job-associated burnout
- Stigma and harm associated with seeking help (having to report this condition on your license, and to your hospital)
What I find interesting are the responses you get from physicians when you ask about what actions can be taken to reduce burnout. Not shorter hours / more pay.
- Reducing low-value work & EHR clicks
- Eliminating insurance barriers like #PriorAuth
- Reducing low-value work & EHR clicks
- Eliminating insurance barriers like #PriorAuth
These factors don't just affect physicians. Nurses, RTs, MAs, CNAs & more are harmed.
We are in a work-force crisis. We should be looking to protect the people we have.
Forget the mindfulness exercises.
Reduce EHR burdens.
Reduce box-checking.
#FixPriorAuth.
@MedicineForward
We are in a work-force crisis. We should be looking to protect the people we have.
Forget the mindfulness exercises.
Reduce EHR burdens.
Reduce box-checking.
#FixPriorAuth.
@MedicineForward
Denial of care saga, part 3.
Concierge for @AnthemBCBS reached out, very friendly. Talked to MD reviewer (adult internist) who said, yeah, makes total sense, but I am a Level 1 reviewer and can't approve your request. 🤦♀️
Level 2 reviewer (peds GI) cannot be called directly. 1/x
Concierge for @AnthemBCBS reached out, very friendly. Talked to MD reviewer (adult internist) who said, yeah, makes total sense, but I am a Level 1 reviewer and can't approve your request. 🤦♀️
Level 2 reviewer (peds GI) cannot be called directly. 1/x
Patient's peds GI stayed in the office until 11:00 pm last night finishing a multi-page letter of evidence & justification and attaching additional clinical documentation. Sent it off.
And ... now we wait?
Meanwhile this child is on high dose steroids with no endpoint. 2/x
And ... now we wait?
Meanwhile this child is on high dose steroids with no endpoint. 2/x
My colleague says there is a national peds GI listserv replete with stories of patients just like ours, including stories of people dying while waiting for approval.
The longer we wait, the greater the risk that our patient will need a surgery to deal with her inflammation. 3/x
The longer we wait, the greater the risk that our patient will need a surgery to deal with her inflammation. 3/x
🧵 @AmerMedicalAssn Prez @GeraldHarmonMD stated:
An investigation by @OIGatHHS “into the inappropriate use of #PriorAuthorization by Medicare Advantage plans uncovered information that mirrors physician experiences.”
Read report: oig.hhs.gov/oei/reports/OE…
An investigation by @OIGatHHS “into the inappropriate use of #PriorAuthorization by Medicare Advantage plans uncovered information that mirrors physician experiences.”
Read report: oig.hhs.gov/oei/reports/OE…
2/ “Surveys of physicians have consistently found that excessive authorization controls required by health insurers are persistently responsible for serious harm when necessary medical care is delayed, denied, or disrupted.” #FixPriorAuth
See 2021 survey: ama-assn.org/system/files/p…
See 2021 survey: ama-assn.org/system/files/p…
3/ “The American Medical Association agrees with the federal investigators’ recommendations for preventing inappropriate use of authorization controls to delay, deny and disrupt patient care, but more needs to be done to reform prior authorization.”
1/ @AmerMedicalAssn press release on the urgency to #fixpriorauth:
At the height of the #COVID19 #pandemic, physicians reported being bedeviled by unnecessary, bureaucratic obstacles that the health insurance industry pledged to reduce three years ago.
At the height of the #COVID19 #pandemic, physicians reported being bedeviled by unnecessary, bureaucratic obstacles that the health insurance industry pledged to reduce three years ago.
2/ The data highlights the urgent need for new bipartisan legislation introduced in the House, the Improving Seniors’ Timely Access to Care Act. [TY @RepDelBene @MikeKellyPA @RepBera @RepLarryBucshon for introducing this vital measure.]
[See data here: ama-assn.org/system/files/2…]
[See data here: ama-assn.org/system/files/2…]
3/#OurAMA-conducted survey shows physicians are running into roadblocks because of #priorauthorization, the process of requiring health care professionals to obtain advance approval from health plans before a prescription medication or medical service is delivered to the patient.
