Meeting the Prior Authorization Challenge
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Constant changes to insurance coverage and rising prescription costs have made prior authorizations (PAs), the requirement by a patient’s health plan to approve a specific medication as a condition of providing coverage, a growing concern. Many physicians, and their practice staff, are frustrated by the lengthy, time-consuming, complex process of submitting a PA. Further, PA requirements can stand in the way of patients getting the medication that health care providers believe is most appropriate. In fact, when a PA is required, only 29% of patients receive the originally prescribed drug – and 40% receive no therapy at all. When physicians are able to successfully prescribe the treatment they determine is best for each case, everyone benefits: the physician, and most importantly, the patient. Each episode within this series highlights the importance of having a prior authorization provider on your side - whether you are a doctor or a practice staff member.
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