Most doctors highly dissatisfied with prior authorization process

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An American Medical Association survey of 1,000 physicians finds high dissatisfaction with how manual and electronic prior authorization transactions are handled by health plans.

Last year, another AMA survey found that the most common ways to complete medical and prescription prior authorizations were by using faxes or the telephone. And that still holds true today, as the new survey finds half of physician respondents who electronically prescribe do not know it is possible to complete authorizations while inside the electronic health record.

Further, 92 percent of physician respondents believe prior authorizations have a negative impact on patient clinical outcomes, and a change in how these transactions are handled needs to be found.

Insurers are making it more difficult for physicians to prescribe medications or other services until a physician documents justification for treatment, says Jack Resneck, Jr., MD, chair-elect of AMA. While insurers eventually approve most requests, the process is fraught with excessive paperwork, phone calls and disruptions of care, he adds. “In my own practice, insurers are now requiring prior authorization even for generic medications, which has exponentially increased the daily paperwork burden,” he reports.

Also See: Provider groups ask payers for prior authorization reform

In the AMA survey, 64 percent of surveyed providers say they wait at least one business data for a prior authorization to be approved, and 30 percent report waiting three business days or longer. Further, 78 percent of physicians say delays in getting authorization lead to patients abandoning treatment.

The paperwork has gotten so bad, according to AMA, that a typical practice each week completes about 30 prior authorizations per doctor, which consumes the time of nearly two business days.

Now, AMA is working with health insurer Anthem to find ways to streamline or eliminate low-value prior authorizations to improve continuity of care. The association also encourages use of electronic prior authorizations that are integrated with the electronic health record and don’t disrupt a physician’s workflow.

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