Prior Authorization

Why we fight to fix prior authorization

. 2 MIN READ

The average physician practice completes 45 prior authorizations per physician per week, and doctors and their staff spend nearly two business days a week completing such authorizations.

That’s why the AMA is challenging insurance companies to eliminate care delays, patient harms and practice hassles.

 

Fixing prior authorization

Prior authorization is costly, inefficient and responsible for patient care delays. The AMA stands up to insurance companies to eliminate care delays, patient harm and practice hassles.

Even one day of delay can lead to worse outcomes.

—Fumiko Chino, MD, whose research on cancer patients’ experiences with prior authorization was published in JAMA Network Open.

We as doctors get so frustrated when we recommended a therapy, when we know what a patient needs. And we know we need to have the diagnosis to get that need met. And yet we run into an administrative economic barrier that is not anticipated.

Gerald E. Harmon, MD, family medicine specialist and former AMA president

According to the most recent AMA survey (PDF), 89% of respondents said prior authorization had a significant or somewhat negative clinical impact, with 33% reporting that prior authorization had led to a serious adverse event such as a death, hospitalization, disability or permanent bodily damage, or other life-threatening event for a patient in their care.

  1. How the AMA is fixing prior authorization

  2. Clearing up what's required and when

  3. Fighting for peer-to-peer insurance review

  4. AMA advocacy wins on prior authorization

We need your help

Become a member and help the AMA stand up to insurance companies and fix overuse of prior authorization.

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