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Dr. Amanda Williams, President of the Medical Association of the State of Alabama, recently spoke out on Alabama Public Television’s Capitol Journal about a new campaign to reduce delays in patient care caused by prior authorization.
Delays caused by prior authorization are a growing problem that leave frustrated patients stuck waiting for medical care their doctors say they need.
“You have a patient who has just come in and they’re excited to feel better. They’re finally getting the treatment that they need or the diagnostic test that they need and then they’re hit with more delays,” Dr. Williams said of prior authorization requirements. “From a patient’s perspective, it can be very disheartening.”
Prior authorizations were once reserved for high-cost treatments, but today, even routine care can be delayed or denied because of these insurance requirements.
According to Dr. Williams, prior authorization is more than just a nuisance; it can significantly impact a patient’s health and well-being.
“The problem is it has now morphed into requiring paperwork for very routine medications, routine imaging, routine care and it causes significant delays in treatment,” said Dr. Williams. “Usually it can take days to get a response and often it will just be a denial and require an appeal and then take even longer. So it can really slow up treatment.”
Physicians are feeling the strain of prior authorization as well, with entire teams now dedicated solely to navigating the red tape.
“We have entire staff that their whole job is doing prior authorizations,” Dr. Williams said.
Prior authorizations also result in fewer patients being seen by physicians. A survey of Alabama doctors found that 76 percent said the time they spend on prior authorizations means they see fewer patients in a day. One-third of doctors said they and their staff spend nearly an entire workday each week filling out prior authorization paperwork, following up with phone calls and fighting denials.
In response, the Medical Association and a coalition of health care partners has launched a new online platform—www.ALFixPriorAuth.com—where Alabamians can share their stories of prior authorization roadblocks. The website and the initiative behind it aim to encourage faster insurance approvals for needed medical care.
Physicians are calling for important reforms, including eliminating repeat authorizations for chronic conditions and quicker responses from insurers. The stories submitted through the website will be crucial in driving these changes.
Watch Dr. Williams’s full interview on Capitol Journal here.
