Prior authorization continues to delay patient care and treatment, impact outcomes, and drive up health care costs for all Hoosiers. Physician offices advocate for their patients but are forced to waste valuable time and resources on these burdens.
Your stories about how prior authorization impacts patients are a powerful way to help ISMA put
Patients Over Prior Auth.
Please participate in ISMA’s advocacy initiative by sending us the latest example(s) of payors inappropriately putting prior auth over patients. More than 110 stories have already been submitted to ISMA since the short intake form went live earlier this year.
There is no limit on the number of submissions you can make. In fact, the more examples we have, the more impactful it will be -- even if they are repetitive.
Sam Horton, MD, shared: “I was asked to do a peer to peer for CPAP supplies on a regular CPAP user. Begrudgingly, I called CareSource (Marketplace Indiana) but couldn't get past the representative while trying to arrange a 'peer to peer.' The representative said they couldn't arrange the conversation without an authorization. However, I couldn't get across to him that this was the peer-to-peer line (they later confirmed it was). I was calling to GET the authorization. Thirty minutes later, at the end of lunch, I gave up. My patient will now have to wait 180 days (rules the insurance created, because the peer to peer wasn't completed) to get new supplies. And I feel more sorry for the truly sick patients whose telephone calls couldn't be answered, and for the early afternoon patients who didn't get my full attention because I was still fuming over the complete waste of time.”
Visit
www.ismanet.org/PatientsOverPriorAuth to share your story and read several others.
Please consider sharing this article with your colleagues, even if
they’re not ISMA members. We want to hear from as many Hoosier physicians as
possible.
Thank you for continuing to advocate for the well-being of all Hoosiers. Your participation in this
Patients Over Prior Auth initiative will help bring about vital change.
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